title: Prediction of radiation pneumonitis in lung cancer patients: a systematic review.
abstract: OBJECTIVE
  Factors prediction in the development of radiation pneumonitis (RP) remains unclear. A meta-analysis about this was performed.
  
  
  METHODS
  Articles were searched in February 2012 from PubMed, EMBASE, Cochrane Library and CNKI (Chinese Journal Full-text Database) using the keywords "lung cancer," "radiation pneumonitis" or "radiation lung injury." The outcome was the RP incidence. We pooled the data using RevMan 5.1 software and tested the statistical heterogeneity.
  
  
  RESULTS
  We included the following factors: age, gender, weight loss, smoking history, complications, performance status, pre-radiation therapy (RT) pulmonary function, TNM, histological type, tumor location, pre-RT surgery, RT combined with chemotherapy (RCT), RT/RCT combined with amifostine, plasma end/pre-RT TGF-β1 ratio and irradiation volume. The significant risk factors for RP ≥ grade 2 were patients with chronic lung disease, tumor located in the middle or lower lobe, without pre-RT surgery, RCT, plasma end/pre-RT TGF-β1 ratio ≥1 and gross tumor volume (GTV). Following factors were identified significant for RP, including tumor located not in the upper lobe, smokers, combined with chronic lung diseases or diabetes mellitus, low pre-RT pulmonary function, RCT, RT/RCT without amifostine and plasma end/pre-RT TGF-β1 ratio ≥1. Dose-volume parameters included the average of mean lung dose (MLD) of disease lung, GTV and V                   (5), V                   (10) (≥34 %), V                   (20) (≥25 %), V                   (30) (≥18 %) of bilateral lung.
  
  
  CONCLUSIONS
  More attention should be paid to the levels of patients' pulmonary function, plasma TGF-β1 and dose-volume histogram (DVH). Rigorous studies are needed to identify the relationship between the above-mentioned factors and RP ≥grade 1 or 3.
authors: Cancer Institute of People's Liberation Army, Xinqiao Hospital, Third Military Medical University, Chongqing, People's Republic of China. zhangxiaojing01@163.com
authors: Xiao-Jing
authors: XJ
authors: Zhang
authors: Jian-Guo
authors: JG
authors: Sun
authors: Jie
authors: J
authors: Sun
authors: Hua
authors: H
authors: Ming
authors: Xin-Xin
authors: XX
authors: Wang
authors: Lei
authors: L
authors: Wu
authors: Zheng-Tang
authors: ZT
authors: Chen
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000532:radiotherapy*; D008297:Male; D009367:Neoplasm Staging / Q000379:methods; D017564:Radiation Pneumonitis / Q000209:etiology* / Q000378:metabolism / Q000473:pathology*; D011879:Radiotherapy Dosage; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D053773:Transforming Growth Factor beta1 / Q000378:metabolism
chemical_list: D053773:Transforming Growth Factor beta1