title: Risk factors for radiation-induced lung toxicity in patients with non-small cell lung cancer who received postoperative radiation therapy.
abstract: OBJECTIVE
  To evaluate the risk factors for radiation-induced lung toxicity (RILT) from post-operative radiation therapy (PORT) in patients with non-small cell lung cancer (NSCLC).
  
  
  METHODS
  Ninety NSCLC patients who received PORT with or without chemotherapy from November 2002 to March 2006 were retrospectively analyzed. Each individual's radiotherapy plans were reviewed to determine the percentage of the whole lung volume that received more than a specific dose of irradiation (V(dose)). The endpoint was RILT of grade 2 or higher. Data of potential risk factors for RILT were extracted from the medical records and evaluated by logistic regression modeling, the t-test, and the Chi-square test.
  
  
  RESULTS
  A total of 20 patients received pneumonectomy, while the remaining 70 received lobectomy. In the lobectomy group, 9 patients (10%) developed ≥grade 2 RILT. Among the clinical factors, only adjuvant chemotherapy was significantly correlated with RILT (p=0.039). For lung dosimetric factors, V(20) through V(40) were all significantly higher in the RILT group than in the non-RILT group. In the lobectomy group, the incidence of RILT was 27.3% in patients who received adjuvant chemotherapy and whose V(20) was greater than 20%. It was 9.7% in lobectomy patients with one of the risk factors, and 0.0% in those with no risk factors (p=0.032).
  
  
  CONCLUSIONS
  The lung toxicity of PORT was found to be acceptably low. Adjuvant chemotherapy and lung dosimetric factors of V(20)-V(40) were significantly correlated with RILT risk in NSCLC patients.
authors.affiliation: Department of Radiation Oncology, Cancer Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100021, China.
authors.forename: Lujun
authors.initials: L
authors.lastname: Zhao
authors.forename: Wei
authors.initials: W
authors.lastname: Ji
authors.forename: Guangfei
authors.initials: G
authors.lastname: Ou
authors.forename: Jima
authors.initials: J
authors.lastname: Lv
authors.forename: Jun
authors.initials: J
authors.lastname: Liang
authors.forename: Qinfu
authors.initials: Q
authors.lastname: Feng
authors.forename: Zongmei
authors.initials: Z
authors.lastname: Zhou
authors.forename: Luhua
authors.initials: L
authors.lastname: Wang
authors.forename: Weibo
authors.initials: W
authors.lastname: Yin
mesh_terms: D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications* / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D055370:Lung Injury / Q000209:etiology*; D008175:Lung Neoplasms / Q000150:complications* / Q000532:radiotherapy* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011832:Radiation Injuries; D012307:Risk Factors