Heart Irradiation As a Risk Factor for Radiation Pneumonitis

Overview

Journal Acta Oncol

Specialty Oncology

Date 2010 Sep 30

PMID 20874426

Citations 53

Authors

Ellen X Huang

Andrew J Hope

Patricia E Lindsay

Marco Trovo

Issam El Naqa

Joseph O Deasy

Jeffrey D Bradley

Affiliations

Soon will be listed here.

Abstract

Purpose: to investigate the potential role of incidental heart irradiation on the risk of radiation pneumonitis (RP) for patients receiving definitive radiation therapy for non-small-cell lung cancer (NSCLC).

Material And Methods: two hundred and nine patient datasets were available for this study. Heart and lung dose-volume parameters were extracted for modeling, based on Monte Carlo-based heterogeneity corrected dose distributions. Clinical variables tested included age, gender, chemotherapy, pre-treatment weight-loss, performance status, and smoking history. The risk of RP was modeled using logistic regression.

Results: the most significant univariate variables were heart related, such as heart heart V65 (percent volume receiving at least 65 Gy) (Spearman Rs = 0.245, p < 0.001). The best-performing logistic regression model included heart D10 (minimum dose to the hottest 10% of the heart), lung D35, and maximum lung dose (Spearman Rs = 0.268, p < 0.0001). When classified by predicted risk, the RP incidence ratio between the most and least risky 1/3 of treatments was 4.8. The improvement in risk modeling using lung and heart variables was better than using lung variables alone.

Conclusions: these results suggest a previously unsuspected role of heart irradiation in many cases of RP.

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