Department of Radiation Oncology, Yokohama City University Medical Center, Yokohama, Japan;
Department of Radiation Oncology, Yokohama City University Medical Center, Yokohama, Japan.
In Vivo. 2021 Nov-Dec;35(6):3441-3448. doi: 10.21873/invivo.12644.
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.
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.
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%.
Pneumonitis V15 <87.10% was a risk factor for G2 pneumonitis.
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。
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。
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。
肺炎 V15<87.10%是 G2 级肺炎的危险因素。
