File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)
Supplementary

Article: Radiation-induced lung toxicity in non-small-cell lung cancer: Understanding the interactions of clinical factors and cytokines with the dose-toxicity relationship

TitleRadiation-induced lung toxicity in non-small-cell lung cancer: Understanding the interactions of clinical factors and cytokines with the dose-toxicity relationship
Authors
KeywordsNon-small-cell lung cancer
Lung toxicity
Cytokine
Biomarker
Radiotherapy
Issue Date2017
Citation
Radiotherapy and Oncology, 2017, v. 125, n. 1, p. 66-72 How to Cite?
Abstract© 2017 Elsevier B.V. Background and purpose Current methods to estimate risk of radiation-induced lung toxicity (RILT) rely on dosimetric parameters. We aimed to improve prognostication by incorporating clinical and cytokine data, and to investigate how these factors may interact with the effect of mean lung dose (MLD) on RILT. Materials and methods Data from 125 patients treated from 2004 to 2013 with definitive radiotherapy for stages I-III NSCLC on four prospective clinical trials were analyzed. Plasma levels of 30 cytokines were measured pretreatment, and at 2 and 4 weeks midtreatment. Penalized logistic regression models based on combinations of MLD, clinical factors, and cytokine levels were developed. Cross-validated estimates of log-likelihood and area under the receiver operating characteristic curve (AUC) were used to assess accuracy. Results In prognosticating grade 3 or greater RILT by MLD alone, cross-validated log-likelihood and AUC were −28.2 and 0.637, respectively. Incorporating clinical features and baseline cytokine levels increased log-likelihood to −27.6 and AUC to 0.669. Midtreatment cytokine data did not further increase log-likelihood or AUC. Of the 30 cytokines measured, higher levels of 13 decreased the effect of MLD on RILT, corresponding to a lower odds ratio for RILT per Gy MLD, while higher levels of 4 increased the association. Conclusions Although the added prognostic benefit from cytokine data in our model was modest, understanding how clinical and biologic factors interact with the MLD-RILT relationship represents a novel framework for understanding and investigating the multiple factors contributing to radiation-induced toxicity.
Persistent Identifierhttp://hdl.handle.net/10722/267079
ISSN
2017 Impact Factor: 4.942
2015 SCImago Journal Rankings: 2.654
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorHawkins, Peter G.-
dc.contributor.authorBoonstra, Philip S.-
dc.contributor.authorHobson, Stephen T.-
dc.contributor.authorHearn, Jason W.D.-
dc.contributor.authorHayman, James A.-
dc.contributor.authorTen Haken, Randall K.-
dc.contributor.authorMatuszak, Martha M.-
dc.contributor.authorStanton, Paul-
dc.contributor.authorKalemkerian, Gregory P.-
dc.contributor.authorRamnath, Nithya-
dc.contributor.authorLawrence, Theodore S.-
dc.contributor.authorSchipper, Matthew J.-
dc.contributor.author(Spring) Kong, Feng Ming-
dc.contributor.authorJolly, Shruti-
dc.date.accessioned2019-01-31T07:20:27Z-
dc.date.available2019-01-31T07:20:27Z-
dc.date.issued2017-
dc.identifier.citationRadiotherapy and Oncology, 2017, v. 125, n. 1, p. 66-72-
dc.identifier.issn0167-8140-
dc.identifier.urihttp://hdl.handle.net/10722/267079-
dc.description.abstract© 2017 Elsevier B.V. Background and purpose Current methods to estimate risk of radiation-induced lung toxicity (RILT) rely on dosimetric parameters. We aimed to improve prognostication by incorporating clinical and cytokine data, and to investigate how these factors may interact with the effect of mean lung dose (MLD) on RILT. Materials and methods Data from 125 patients treated from 2004 to 2013 with definitive radiotherapy for stages I-III NSCLC on four prospective clinical trials were analyzed. Plasma levels of 30 cytokines were measured pretreatment, and at 2 and 4 weeks midtreatment. Penalized logistic regression models based on combinations of MLD, clinical factors, and cytokine levels were developed. Cross-validated estimates of log-likelihood and area under the receiver operating characteristic curve (AUC) were used to assess accuracy. Results In prognosticating grade 3 or greater RILT by MLD alone, cross-validated log-likelihood and AUC were −28.2 and 0.637, respectively. Incorporating clinical features and baseline cytokine levels increased log-likelihood to −27.6 and AUC to 0.669. Midtreatment cytokine data did not further increase log-likelihood or AUC. Of the 30 cytokines measured, higher levels of 13 decreased the effect of MLD on RILT, corresponding to a lower odds ratio for RILT per Gy MLD, while higher levels of 4 increased the association. Conclusions Although the added prognostic benefit from cytokine data in our model was modest, understanding how clinical and biologic factors interact with the MLD-RILT relationship represents a novel framework for understanding and investigating the multiple factors contributing to radiation-induced toxicity.-
dc.languageeng-
dc.relation.ispartofRadiotherapy and Oncology-
dc.subjectNon-small-cell lung cancer-
dc.subjectLung toxicity-
dc.subjectCytokine-
dc.subjectBiomarker-
dc.subjectRadiotherapy-
dc.titleRadiation-induced lung toxicity in non-small-cell lung cancer: Understanding the interactions of clinical factors and cytokines with the dose-toxicity relationship-
dc.typeArticle-
dc.description.natureLink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.radonc.2017.09.005-
dc.identifier.pmid28947099-
dc.identifier.scopuseid_2-s2.0-85029756714-
dc.identifier.volume125-
dc.identifier.issue1-
dc.identifier.spage66-
dc.identifier.epage72-
dc.identifier.eissn1879-0887-
dc.identifier.isiWOS:000413883500010-

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats