Department of Radiation Oncology, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea.
Cancer Res Treat. 2013 Dec;45(4):295-302. doi: 10.4143/crt.2013.45.4.295. Epub 2013 Dec 31.
Predictive factors for radiation pneumonitis (RP) after helical tomotherapy (HT) may differ from those after linac-based radiotherapy. In this study, we identified predictive factors for RP in patients with lung cancer treated with HT.
We retrospectively analyzed clinical, treatment-related and dosimetric factors from 31 patients with lung cancer treated with HT. RP was graded according to Common Terminology Criteria for Adverse Events version 4.0 and grade ≥2 RP was defined as a RP event. We used Kaplan-Meier methods to compute the actuarial incidence of RP. For univariate and multivariate analysis, the log-rank test and the Cox proportional regression hazard model were used. We generated receiver-operating characteristics (ROC) curves to define the cutoff values for significant parameters.
The median follow-up duration was 6.6 months (range, 1.6 to 38.5 months). The 2-, 4-, and 6-month actuarial RP event rates were 13.2%, 58.5%, and 67.0%, respectively. There was no grade 4 or more RP. Ipsilateral V5, V10, V15, and contralateral V5 were related with RP event on univariate analysis. By multivariate analysis, ipsilateral V10 was factor most strongly associated with RP event. On the ROC curve, the cutoff values of ipsilateral V5, V10, V15, and contralateral V5 were 67.5%, 58.5%, 50.0%, and 55.5%, respectively.
In our study, ipsilateral V5, V10, V15, and contralateral V5 were significant predictive factors for RP after HT.
螺旋断层放疗（HT）后放射性肺炎（RP）的预测因素可能与直线加速器放疗后不同。本研究旨在确定接受 HT 治疗的肺癌患者发生 RP 的预测因素。
我们回顾性分析了 31 例接受 HT 治疗的肺癌患者的临床、治疗相关和剂量学因素。RP 按不良事件通用术语标准 4.0 版进行分级，≥2 级 RP 定义为 RP 事件。我们使用 Kaplan-Meier 方法计算 RP 的累积发生率。采用对数秩检验和 Cox 比例风险回归模型进行单因素和多因素分析。我们生成了受试者工作特征（ROC）曲线来确定显著参数的截断值。
中位随访时间为 6.6 个月（范围 1.6 至 38.5 个月）。2、4 和 6 个月的累积 RP 事件发生率分别为 13.2%、58.5%和 67.0%。无 4 级或更高级别的 RP。单因素分析显示，同侧 V5、V10、V15 和对侧 V5 与 RP 事件相关。多因素分析显示，同侧 V10 是与 RP 事件最相关的因素。ROC 曲线显示，同侧 V5、V10、V15 和对侧 V5 的截断值分别为 67.5%、58.5%、50.0%和 55.5%。
在本研究中，同侧 V5、V10、V15 和对侧 V5 是 HT 后 RP 的显著预测因素。
