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Conference Paper: Simple Factors Associated With Radiation-Induced Lung Toxicity After Stereotactic Body Radiation Therapy of the Thorax: A Pooled Analysis of 88 Studies

TitleSimple Factors Associated With Radiation-Induced Lung Toxicity After Stereotactic Body Radiation Therapy of the Thorax: A Pooled Analysis of 88 Studies
Authors
Issue Date2016
Citation
International Journal of Radiation Oncology Biology Physics, 2016, v. 95, n. 5, p. 1357-1366 How to Cite?
Abstract© 2016 Purpose To study the risk factors for radiation-induced lung toxicity (RILT) after stereotactic body radiation therapy (SBRT) of the thorax. Methods and Materials Published studies on lung toxicity in patients with early-stage non–small cell lung cancer (NSCLC) or metastatic lung tumors treated with SBRT were pooled and analyzed. The primary endpoint was RILT, including pneumonitis and fibrosis. Data of RILT and risk factors were extracted from each study, and rates of grade 2 to 5 (G2+) and grade 3 to 5 (G3+) RILT were computed. Patient, tumor, and dosimetric factors were analyzed for their correlation with RILT. Results Eighty-eight studies (7752 patients) that reported RILT incidence were eligible. The pooled rates of G2+ and G3+ RILT from all 88 studies were 9.1% (95% confidence interval [CI]: 7.15-11.4) and 1.8% (95% CI: 1.3-2.5), respectively. The median of median tumor sizes was 2.3 (range, 1.4-4.1) cm. Among the factors analyzed, older patient age (P=.044) and larger tumor size (the greatest diameter) were significantly correlated with higher rates of G2+ (P=.049) and G3+ RILT (P=.001). Patients with stage IA versus stage IB NSCLC had significantly lower risks of G2+ RILT (8.3% vs 17.1%, odds ratio = 0.43, 95% CI: 0.29-0.64, P<.0001). Among studies that provided detailed dosimetric data, the pooled analysis demonstrated a significantly higher mean lung dose (MLD) (P=.027) and V20 (P=.019) in patients with G2+ RILT than in those with grade 0 to 1 RILT. Conclusions The overall rate of RILT is relatively low after thoracic SBRT. Older age and larger tumor size are significant adverse risk factors for RILT. Lung dosimetry, specifically lung V20 and MLD, also significantly affect RILT risk.
Persistent Identifierhttp://hdl.handle.net/10722/267057
ISSN
2017 Impact Factor: 5.554
2015 SCImago Journal Rankings: 2.274
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorZhao, Jing-
dc.contributor.authorYorke, Ellen D.-
dc.contributor.authorLi, Ling-
dc.contributor.authorKavanagh, Brian D.-
dc.contributor.authorLi, X. Allen-
dc.contributor.authorDas, Shiva-
dc.contributor.authorMiften, Moyed-
dc.contributor.authorRimner, Andreas-
dc.contributor.authorCampbell, Jeffrey-
dc.contributor.authorXue, Jinyu-
dc.contributor.authorJackson, Andrew-
dc.contributor.authorGrimm, Jimm-
dc.contributor.authorMilano, Michael T.-
dc.contributor.authorSpring Kong, Feng Ming-
dc.date.accessioned2019-01-31T07:20:23Z-
dc.date.available2019-01-31T07:20:23Z-
dc.date.issued2016-
dc.identifier.citationInternational Journal of Radiation Oncology Biology Physics, 2016, v. 95, n. 5, p. 1357-1366-
dc.identifier.issn0360-3016-
dc.identifier.urihttp://hdl.handle.net/10722/267057-
dc.description.abstract© 2016 Purpose To study the risk factors for radiation-induced lung toxicity (RILT) after stereotactic body radiation therapy (SBRT) of the thorax. Methods and Materials Published studies on lung toxicity in patients with early-stage non–small cell lung cancer (NSCLC) or metastatic lung tumors treated with SBRT were pooled and analyzed. The primary endpoint was RILT, including pneumonitis and fibrosis. Data of RILT and risk factors were extracted from each study, and rates of grade 2 to 5 (G2+) and grade 3 to 5 (G3+) RILT were computed. Patient, tumor, and dosimetric factors were analyzed for their correlation with RILT. Results Eighty-eight studies (7752 patients) that reported RILT incidence were eligible. The pooled rates of G2+ and G3+ RILT from all 88 studies were 9.1% (95% confidence interval [CI]: 7.15-11.4) and 1.8% (95% CI: 1.3-2.5), respectively. The median of median tumor sizes was 2.3 (range, 1.4-4.1) cm. Among the factors analyzed, older patient age (P=.044) and larger tumor size (the greatest diameter) were significantly correlated with higher rates of G2+ (P=.049) and G3+ RILT (P=.001). Patients with stage IA versus stage IB NSCLC had significantly lower risks of G2+ RILT (8.3% vs 17.1%, odds ratio = 0.43, 95% CI: 0.29-0.64, P<.0001). Among studies that provided detailed dosimetric data, the pooled analysis demonstrated a significantly higher mean lung dose (MLD) (P=.027) and V20 (P=.019) in patients with G2+ RILT than in those with grade 0 to 1 RILT. Conclusions The overall rate of RILT is relatively low after thoracic SBRT. Older age and larger tumor size are significant adverse risk factors for RILT. Lung dosimetry, specifically lung V20 and MLD, also significantly affect RILT risk.-
dc.languageeng-
dc.relation.ispartofInternational Journal of Radiation Oncology Biology Physics-
dc.titleSimple Factors Associated With Radiation-Induced Lung Toxicity After Stereotactic Body Radiation Therapy of the Thorax: A Pooled Analysis of 88 Studies-
dc.typeConference_Paper-
dc.description.natureLink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.ijrobp.2016.03.024-
dc.identifier.pmid27325482-
dc.identifier.scopuseid_2-s2.0-84990847965-
dc.identifier.volume95-
dc.identifier.issue5-
dc.identifier.spage1357-
dc.identifier.epage1366-
dc.identifier.eissn1879-355X-
dc.identifier.isiWOS:000380562300007-

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