Characteristics of patients who developed radiation pneumonitis requiring steroid therapy after stereotactic irradiation for lung tumors.
BACKGROUND
To find possible risk factors for symptomatic radiation pneumonitis (RP) after stereotactic irradiation (STI) for peripheral non-small cell lung cancer (NSCLC), pre-treatment pulmonary function test and dose volume statistics in patients who developed RP requiring steroid intake were retrospectively compared with statistics of those who did not develop RP.


METHODS
From 1996 to 2002, 156 patients with Stage I NSCLC received STI at 5 hospitals in Japan. Of those patients, 12 were medicated with steroids for RP after treatment (RP group). For comparison, 31 patients were randomly selected from the remaining 144 patients who received STI but did not receive steroids (control group).


RESULTS
There were no statistical differences in age, sex, tumor size, performance status, forced expiratory volume in 1 sec (FEV1.0%), or percent vital capacity (%VC) between patients medicated with steroids for RP and those who did not have RP and received no steroids. V20 (%) was 7 to 18% (median 8%) in patients medicated with steroids for RP and 2 to 16% (median 7%) in those who did not have RP. No difference was observed in V20, the biologically effectively dose (BED) at the periphery of the planning target volume, or the dose per fraction between the two groups.


CONCLUSIONS
Pre-treatment pulmonary function test (%VC, FEV1.0%), and dose volume statistics V20, total dose, BED, dose per fraction, peripheral dose) were not predictive of RP requiring steroid intake after STI for stage I NSCLC.
Fujino
Masaharu
M
Department of Radiology, Hokkaido University School of Medicine, Hokkaido, Sapporo, Japan. mfujino@radi.med.hokudai.ac.jp
Shirato
Hiroki
H
Onishi
Hiroshi
H
Kawamura
Hidemasa
H
Takayama
Kenji
K
Koto
Masashi
M
Onimaru
Rikiya
R
Nagata
Yasushi
Y
Hiraoka
Masahiro
M
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D017564:Radiation Pneumonitis / Q000188:drug therapy / Q000209:etiology*; D011879:Radiotherapy Dosage; D011881:Radiotherapy, Computer-Assisted / Q000009:adverse effects; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012307:Risk Factors; D013238:Stereotaxic Techniques
D000305:Adrenal Cortex Hormones