Rades Dirk, Delikanli Cansu, Doehring Laura, Janssen Stefan, Bohnet Sabine, Groh Elisa M
Department of Radiation Oncology, University of Lübeck, Lübeck, Germany;
Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Lübeck, Germany.
In Vivo. 2025 Sep-Oct;39(5):2818-2823. doi: 10.21873/invivo.14081.
BACKGROUND/AIM: Elderly and very elderly patients with lung cancer have a comparably high risk of radiation pneumonitis (RP). Risk scores may help to identify these patients. We have developed a risk score for very elderly patients.
Nine characteristics were retrospectively investigated in 21 patients aged ≥80 years for associations with symptomatic RP. Characteristics achieving significance or showing a trend were incorporated in the score, which was compared to a previous tool without age limit.
The incidence of RP was 33.3% and significantly associated with mean lung dose (MLD) >20 Gy. Trends were found for MLD >13 Gy and cardiovascular disease. Based on these characteristics, three risk groups were formed (2-5, 7-9, and 12 points). RP rates were 0.0%, 44.4%, and 100.0%. Positive (PPV) and negative (NPV) predictive values were both 100.0%. When using the previous score, PPV and NPV were 71.4% and 100%.
Given the limitations of this study, the newly developed age-specific risk score appears to be a valuable tool for identifying very elderly lung cancer patients at high or low risk of radiation pneumonitis, and may offer improved predictive performance over previously established models.
背景/目的：老年及高龄肺癌患者发生放射性肺炎（RP）的风险相对较高。风险评分可能有助于识别这些患者。我们已开发出一种针对高龄患者的风险评分。
对21例年龄≥80岁的患者进行回顾性研究，调查9项特征与症状性RP的相关性。具有显著性或呈趋势性的特征被纳入评分，并与先前无年龄限制的工具进行比较。
RP的发生率为33.3%，且与平均肺剂量（MLD）>20 Gy显著相关。发现MLD>13 Gy和心血管疾病呈趋势性。基于这些特征，形成了三个风险组（2 - 5分、7 - 9分和12分）。RP发生率分别为0.0%、44.4%和100.0%。阳性预测值（PPV）和阴性预测值（NPV）均为100.0%。使用先前的评分时，PPV和NPV分别为71.4%和100%。
鉴于本研究的局限性，新开发的年龄特异性风险评分似乎是识别放射性肺炎高风险或低风险的高龄肺癌患者的有价值工具，且可能比先前建立的模型具有更好的预测性能。
