Outcome and prognostic factors for patients with non-small-cell lung cancer and severe radiation pneumonitis.
OBJECTIVE
Radiation pneumonitis is a serious complication that develops after thoracic irradiation. The purpose of this study was to identify prognostic factors for severe radiation pneumonitis in patients with non-small-cell lung cancer.


METHODS
The medical records of patients with non-small-cell lung cancer and severe radiation pneumonitis were reviewed. Variables were analyzed by univariate and stepwise multivariate analysis using the Cox regression model.


RESULTS
Among the 31 patients, the mortality rate approached 50% in the first 2 months after the onset of radiation pneumonitis. The variables significantly associated with survival in the univariate analysis were tumor histologic feature, grade and extent (out-of-field or in-field) of radiation pneumonitis, oxygenation index, and serum albumin (<35 g/L or >or=35 g/L), and uric acid levels at the onset of radiation pneumonitis. Only the extent of radiation pneumonitis and serum albumin level were independently associated with survival in the multivariate analysis.


CONCLUSIONS
The mortality rate of non-small-cell lung cancer patients with severe radiation pneumonitis is extremely high, and survival is much shorter in patients with out-of-field radiation pneumonitis or a low serum albumin level at the onset. Additional studies to investigate the factors precipitating out-of-field radiation pneumonitis should improve the management of irradiation complications.
Wang
Jann-Yuan
JY
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Chen
Kuan-Yu
KY
Wang
Jann-Tay
JT
Chen
Jen-Hau
JH
Lin
Jou-Wei
JW
Wang
Hao-Chien
HC
Lee
Li-Na
LN
Yang
Pan-Chyr
PC
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality* / Q000532:radiotherapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality* / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D017564:Radiation Pneumonitis / Q000401:mortality*; D011879:Radiotherapy Dosage; D016019:Survival Analysis; D016896:Treatment Outcome