Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China.
Institute of Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China.
Int J Radiat Biol. 2024;100(2):248-255. doi: 10.1080/09553002.2023.2261549. Epub 2024 Jan 29.
The relationship among body mass index (BMI), setup error and radiation pneumonitis is not clearly illustrated.
The present study aimed to investigate the role of BMI in non-small cell lung cancer (NSCLC) patients' radiation treatment, focusing on its relationship with setup error of patient positioning, the dosimetric parameters of intensity-modulated radiation therapy (IMRT) and the incidence of radiation pneumonitis.
This prospective observational study included 523 cases of NSCLC patients during 2020-2022. Patients were divided into different groups by different BMI. The setup error was obtained by cone beam CT (CBCT) at three positions, lateral (LAT), longitudinal (LNG) and vertical (VRT). IMRT dosimetric parameters of , , and mean dose were collected.
Patients with BMI ≥28 kg/m showed significantly higher absolute values of LAT, LNG and VRT, higher , , mean dose, as well as higher total incidence of radiation pneumonitis and grade III radiation pneumonitis compared with patients with BMI <24 kg/m or 24-28 kg/m. Spearman's analysis demonstrated that the absolute values of LAT, LNG and VRT were positively correlated with BMI, and positive correlation existed among BMI, dosimetric parameters and setup errors. ROC curves showed that LAT in setup errors and in dosimetric parameters had the best diagnostic value for prediction of radiation pneumonitis. Only BMI, LAT, and were the independent risk factors for radiation pneumonitis.
Setup error caused by higher BMI might be associated with the dosimetric parameters, as well as the incidence of radiation pneumonitis in NSCLC patients.
体重指数（BMI）、摆位误差与放射性肺炎之间的关系尚未阐明。
本研究旨在探讨 BMI 在非小细胞肺癌（NSCLC）患者放疗中的作用，重点研究其与患者定位摆位误差、调强放疗（IMRT）的剂量学参数以及放射性肺炎发生率的关系。
本前瞻性观察研究纳入了 2020 年至 2022 年间的 523 例 NSCLC 患者。根据不同 BMI 将患者分为不同组。通过锥形束 CT（CBCT）在三个位置（侧位 LAT、纵向 LNG 和垂直 VRT）获取摆位误差。收集 IMRT 的剂量学参数 、 、 和平均剂量。
BMI≥28kg/m2 的患者 LAT、LNG 和 VRT 的绝对值明显更高， 、 、平均剂量更高，且总放射性肺炎发生率和 3 级放射性肺炎发生率更高，与 BMI<24kg/m2 或 24-28kg/m2 的患者相比。Spearman 分析表明，LAT、LNG 和 VRT 的绝对值与 BMI 呈正相关，BMI 与剂量学参数和摆位误差之间存在正相关。ROC 曲线显示，摆位误差中的 LAT 和剂量学参数中的 对预测放射性肺炎具有最佳的诊断价值。只有 BMI、LAT、和 是放射性肺炎的独立危险因素。
较高 BMI 引起的摆位误差可能与 NSCLC 患者的剂量学参数和放射性肺炎发生率有关。
