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Article: Central Airway Toxicity After High Dose Radiation: A Combined Analysis of Prospective Clinical Trials for Non-Small Cell Lung Cancer

TitleCentral Airway Toxicity After High Dose Radiation: A Combined Analysis of Prospective Clinical Trials for Non-Small Cell Lung Cancer
Authors
Issue Date2020
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ijrobp
Citation
International Journal of Radiation Oncology - Biology - Physics, 2020, v. 108 n. 3, p. 587-596 How to Cite?
AbstractPurpose: To study the dosimetric risk factors for radiation-induced proximal bronchial tree (PBT) toxicity in patients treated with radiation therapy for non-small cell lung cancer (NSCLC). Methods and Materials: Patients with medically inoperable or unresectable NSCLC treated with conventionally fractionated 3-dimensional conformal radiation therapy (3DCRT) in prospective clinical trials were eligible for this study. Proximal bronchial tree (PBT) and PBT wall were contoured consistently per RTOG 1106 OAR-Atlas. The dose-volume histograms (DVHs) of physical prescription dose (DVHp) and biological effective dose (α/β = 2.5; DVH2.5) were generated, respectively. The primary endpoint was PBT toxicities, defined by CTCAE 4.0 under the terminology of bronchial stricture/atelectasis. Results: Of 100 patients enrolled, with a median follow-up of 64 months (95% confidence interval [CI], 50-78), 73% received 70 Gy or greater and 17% developed PBT toxicity (grade 1, 8%; grade 2, 6%; grade 3, 0%; and grade 4, 3%). The median time interval between RT initiation and onset of PBT toxicity was 8.4 months (95% CI, 4.7-44.1). The combined DVHs showed that no patient with a PBT maximum physical dose <65 Gy developed any PBT toxicity. Cox proportional hazards analysis and receiver operating characteristic analysis demonstrated that V75 of PBT was the most significant dosimetric parameter for both grade 1+ (P = .035) and grade 2+ (P = .037) PBT toxicities. The dosimetric thresholds for V75 of PBT were 6.8% and 11.9% for grade 1+ and grade 2+ PBT toxicity, respectively. Conclusions: V75 of PBT appeared be the most significant dosimetric parameter for PBT toxicity after conventionally fractionated thoracic 3DCRT. Constraining V75 of PBT can limit clinically significant PBT toxicity.
Persistent Identifierhttp://hdl.handle.net/10722/302110
ISSN
2023 Impact Factor: 6.4
2023 SCImago Journal Rankings: 1.992
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWang, W-
dc.contributor.authorMatuszak, MM-
dc.contributor.authorHu, C-
dc.contributor.authorHuang, KC-
dc.contributor.authorChen, E-
dc.contributor.authorArenberg, D-
dc.contributor.authorCurtis, JL-
dc.contributor.authorJolly, S-
dc.contributor.authorJin, JY-
dc.contributor.authorMachtay, M-
dc.contributor.authorTenHaken, RK-
dc.contributor.authorKong, FMS-
dc.date.accessioned2021-08-21T03:31:43Z-
dc.date.available2021-08-21T03:31:43Z-
dc.date.issued2020-
dc.identifier.citationInternational Journal of Radiation Oncology - Biology - Physics, 2020, v. 108 n. 3, p. 587-596-
dc.identifier.issn0360-3016-
dc.identifier.urihttp://hdl.handle.net/10722/302110-
dc.description.abstractPurpose: To study the dosimetric risk factors for radiation-induced proximal bronchial tree (PBT) toxicity in patients treated with radiation therapy for non-small cell lung cancer (NSCLC). Methods and Materials: Patients with medically inoperable or unresectable NSCLC treated with conventionally fractionated 3-dimensional conformal radiation therapy (3DCRT) in prospective clinical trials were eligible for this study. Proximal bronchial tree (PBT) and PBT wall were contoured consistently per RTOG 1106 OAR-Atlas. The dose-volume histograms (DVHs) of physical prescription dose (DVHp) and biological effective dose (α/β = 2.5; DVH2.5) were generated, respectively. The primary endpoint was PBT toxicities, defined by CTCAE 4.0 under the terminology of bronchial stricture/atelectasis. Results: Of 100 patients enrolled, with a median follow-up of 64 months (95% confidence interval [CI], 50-78), 73% received 70 Gy or greater and 17% developed PBT toxicity (grade 1, 8%; grade 2, 6%; grade 3, 0%; and grade 4, 3%). The median time interval between RT initiation and onset of PBT toxicity was 8.4 months (95% CI, 4.7-44.1). The combined DVHs showed that no patient with a PBT maximum physical dose <65 Gy developed any PBT toxicity. Cox proportional hazards analysis and receiver operating characteristic analysis demonstrated that V75 of PBT was the most significant dosimetric parameter for both grade 1+ (P = .035) and grade 2+ (P = .037) PBT toxicities. The dosimetric thresholds for V75 of PBT were 6.8% and 11.9% for grade 1+ and grade 2+ PBT toxicity, respectively. Conclusions: V75 of PBT appeared be the most significant dosimetric parameter for PBT toxicity after conventionally fractionated thoracic 3DCRT. Constraining V75 of PBT can limit clinically significant PBT toxicity.-
dc.languageeng-
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ijrobp-
dc.relation.ispartofInternational Journal of Radiation Oncology - Biology - Physics-
dc.titleCentral Airway Toxicity After High Dose Radiation: A Combined Analysis of Prospective Clinical Trials for Non-Small Cell Lung Cancer-
dc.typeArticle-
dc.identifier.emailKong, FMS: kong0001@hku.hk-
dc.identifier.authorityKong, FMS=rp02508-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1016/j.ijrobp.2020.05.026-
dc.identifier.pmid32470501-
dc.identifier.pmcidPMC8074530-
dc.identifier.scopuseid_2-s2.0-85087893070-
dc.identifier.hkuros324258-
dc.identifier.volume108-
dc.identifier.issue3-
dc.identifier.spage587-
dc.identifier.epage596-
dc.identifier.isiWOS:000574862100013-
dc.publisher.placeUnited States-

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