title: Stereotactic body radiotherapy for Stage I lung cancer with chronic obstructive pulmonary disease: special reference to survival and radiation-induced pneumonitis.
abstract: This retrospective study aimed to evaluate radiation-induced pneumonitis (RIP) and a related condition that we define in this report--prolonged minimal RIP (pmRIP)--after stereotactic body radiotherapy (SBRT) for Stage I primary lung cancer in patients with chronic obstructive pulmonary disease (COPD). We assessed 136 Stage I lung cancer patients with COPD who underwent SBRT. Airflow limitation on spirometry was classified into four Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades, with minor modifications: GOLD 1 (mild), GOLD 2 (moderate), GOLD 3 (severe) and GOLD 4 (very severe). On this basis, we defined two subgroups: COPD-free (COPD -) and COPD-positive (COPD +). There was no significant difference in overall survival or cause-specific-survival between these groups. Of the 136 patients, 44 (32%) had pmRIP. Multivariate analysis showed that COPD and the Brinkman index were statistically significant risk factors for the development of pmRIP. COPD and the Brinkman index were predictive factors for pmRIP, although our findings also indicate that SBRT can be tolerated in early lung cancer patients with COPD.
authors.affiliation: Miyakojima IGRT Clinic, 1-6-22 Miyakojima Hondori, Miyakojima-ku, Osaka, 534-0021, Japan toinoue@osaka-igrt.or.jp.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Inoue
authors.affiliation: Miyakojima IGRT Clinic, 1-6-22 Miyakojima Hondori, Miyakojima-ku, Osaka, 534-0021, Japan.
authors.forename: Hiroya
authors.initials: H
authors.lastname: Shiomi
authors.affiliation: Miyakojima IGRT Clinic, 1-6-22 Miyakojima Hondori, Miyakojima-ku, Osaka, 534-0021, Japan.
authors.forename: Ryoong-Jin
authors.initials: RJ
authors.lastname: Oh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D015897:Comorbidity; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008175:Lung Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality* / Q000517:prevention & control*; D017564:Radiation Pneumonitis / Q000401:mortality*; D016634:Radiosurgery / Q000401:mortality* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate
keywords: Stage I lung cancer; chronic obstructive pulmonary disease (COPD); prolonged minimal radiation-induced pneumonitis (pmRIP); radiation-induced pneumonitis (RIP); stereotactic body radiotherapy (SBRT)