title: Dyspnea evolution after high-dose radiotherapy in patients with non-small cell lung cancer.
abstract: OBJECTIVE
  To determine what the influence is of dyspnea (CTCAE3.0) before high-dose radiotherapy (RT) on the incidence and severity of subsequent lung toxicity in patients with non-small cell lung cancer (NSCLC).
  
  
  METHODS
  In 197 patients with stage I-III NSCLC maximal dyspnea scores (CTCAE3.0) were obtained prospectively at three time periods: before RT, the first 6 months post-RT and 6-9 months post-RT. Only patients who were clinically progression-free 12 months or more after RT were included, thus minimizing dyspnea due to tumor progression. Time-trends of dyspnea as a function of baseline dyspnea were investigated and correlated with gender, age, chemotherapy, mean lung dose (MLD), lung function parameters (FeV1 and DLCO), stage, PTV dose, overall treatment time and smoking habits.
  
  
  RESULTS
  The proportion developing less, the same or more dyspnea 6-9 months post-treatment according to their baseline dyspnea scores was: Grade 0: none, 82.9%, 17.1%; Grade 1: 21.2%, 51.9%, 26.9%; Grade 2: 27.3%, 54.5%, 18.2%, respectively. Only age was associated with increased dyspnea after RT.
  
  
  CONCLUSIONS
  Patients with dyspnea before therapy have a realistic chance to improve after high-dose radiotherapy. Reporting only dyspnea at one time-point post-RT is insufficient to determine radiation-induced dyspnea.
authors.affiliation: Maastricht University Medical Center, Department of Radiation Oncology (Maastro Clinic), GROW Research Institute, Maastricht, The Netherlands. dirk.deruysscher@maastro.nl
authors.forename: Dirk
authors.initials: D
authors.lastname: De Ruysscher
authors.forename: Cary
authors.initials: C
authors.lastname: Dehing
authors.forename: Shipeng
authors.initials: S
authors.lastname: Yu
authors.forename: Rinus
authors.initials: R
authors.lastname: Wanders
authors.forename: Michel
authors.initials: M
authors.lastname: Ollers
authors.forename: Anne-Marie C
authors.initials: AM
authors.lastname: Dingemans
authors.forename: Gerben
authors.initials: G
authors.lastname: Bootsma
authors.forename: Monique
authors.initials: M
authors.lastname: Hochstenbag
authors.forename: Wiel
authors.initials: W
authors.lastname: Geraedts
authors.forename: Cordula
authors.initials: C
authors.lastname: Pitz
authors.forename: Jean
authors.initials: J
authors.lastname: Simons
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Boersma
authors.forename: Jacques
authors.initials: J
authors.lastname: Borger
authors.forename: Andre
authors.initials: A
authors.lastname: Dekker
authors.forename: Philippe
authors.initials: P
authors.lastname: Lambin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D019540:Area Under Curve; D016190:Carboplatin / Q000008:administration & dosage; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000532:radiotherapy*; D016009:Chi-Square Distribution; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004417:Dyspnea / Q000209:etiology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008168:Lung / Q000528:radiation effects*; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077235:Vinorelbine; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D014747:Vinblastine; D016190:Carboplatin; D002945:Cisplatin; D000077235:Vinorelbine; D000093542:Gemcitabine