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根治性放疗治疗非小细胞肺癌后放射性肺炎与等剂量线的关系。

Relationship Between Radiation Pneumonitis Following Definitive Radiotherapy for Non-small Cell Lung Cancer and Isodose Line.

机构信息

Department of Radiation Oncology, Yokohama City University Medical Center, Yokohama, Japan;

Department of Radiation Oncology, Yokohama City University Medical Center, Yokohama, Japan.

出版信息

In Vivo. 2021 Nov-Dec;35(6):3441-3448. doi: 10.21873/invivo.12644.

Abstract

BACKGROUND/AIM: It is important to identify radiation pneumonitis above Common Terminology Criteria for Adverse Events Grade 2 (G2) in order to safely continue durvalumab maintenance after chemoradiotherapy for advanced lung cancer. The aim of this study was to discover factors that predict pneumonitis above G2.

PATIENTS AND METHODS

A follow-up computed tomography (CT) image was superimposed on the planning CT image using deformable image registration (DIR). The pneumonitis area was contoured on follow-up CT after DIR and the dose-volume histogram parameters of the contoured pneumonitis area were calculated.

RESULTS

V5 (Percentage of total volume receiving ≥5 Gy) to V50 of pneumonitis were significantly lower in patients with G2 pneumonitis than in those with G1 pneumonitis. The pneumonitis V15 was the most significant. The group with pneumonitis V15 <87.10% had significantly more G2 pneumonitis than the group with pneumonitis V15 ≥87.10%.

CONCLUSION

Pneumonitis V15 <87.10% was a risk factor for G2 pneumonitis.

摘要

背景/目的:在接受放化疗治疗晚期肺癌后,为安全继续使用度伐鲁单抗维持治疗,识别出 CTCAE 不良事件通用标准 2 级(G2)以上的放射性肺炎非常重要。本研究旨在发现预测 G2 以上肺炎的因素。

患者和方法

使用形变图像配准(DIR)将随访 CT 图像叠加到计划 CT 图像上。在 DIR 后对随访 CT 进行肺炎区域勾画,并计算勾画肺炎区域的剂量-体积直方图参数。

结果

G2 级肺炎患者的 V5(接受≥5Gy 的总体积百分比)至 V50 明显低于 G1 级肺炎患者。肺炎 V15 是最显著的。肺炎 V15<87.10%的患者发生 G2 级肺炎的比例明显高于肺炎 V15≥87.10%的患者。

结论

肺炎 V15<87.10%是 G2 级肺炎的危险因素。

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