Lack of Dose Dependency for Radiation Pneumonitis After Chemoradiotherapy with the Use of Tomotherapy for Lung Cancer

Overview

Journal Nagoya J Med Sci

Specialty General Medicine

Date 2022 Apr 8

PMID 35392013

Authors

Yutaka Masuoka

Takuhito Tada

Masahiro Tokunaga

Noriko Takeshita

Masaaki Terashima

Shinichi Tsutsumi

Kentaro Ishii

Keiko Shibuya

Affiliations

Soon will be listed here.

Abstract

A 71-year-old man with stage IIB (Union for International Cancer Control, 8 edition) non-small cell lung cancer underwent intensity-modulated radiation therapy with a dose of 66 Gy administered in 33 fractions concomitant with carboplatin and paclitaxel therapy. On computed tomography after completion of radiation therapy, ground-glass opacity, which was larger on the contralateral side, was observed, but it was not observed in the high-dose area on the ipsilateral side. Although the adverse event theoretically shows dose dependency, it was finally diagnosed as radiation pneumonitis. The presence of an atypical distribution of radiation pneumonitis should be recognized to improve the diagnosis, and it is suggested that the relative volume of the normal contralateral lung receiving a dose of ≥5 Gy is a possible risk factor for radiation pneumonitis.

References

Jenkins P, Welsh A . Computed tomography appearance of early radiation injury to the lung: correlation with clinical and dosimetric factors. Int J Radiat Oncol Biol Phys. 2011; 81(1):97-103. DOI: 10.1016/j.ijrobp.2010.05.017. View

Keffer S, Guy C, Weiss E . Fatal Radiation Pneumonitis: Literature Review and Case Series. Adv Radiat Oncol. 2020; 5(2):238-249. PMC: 7136627. DOI: 10.1016/j.adro.2019.08.010. View

Bledsoe T, Nath S, Decker R . Radiation Pneumonitis. Clin Chest Med. 2017; 38(2):201-208. DOI: 10.1016/j.ccm.2016.12.004. View

Kim Y, Hong S, Kong M, Choi J . Predictive factors for radiation pneumonitis in lung cancer treated with helical tomotherapy. Cancer Res Treat. 2014; 45(4):295-302. PMC: 3893327. DOI: 10.4143/crt.2013.45.4.295. View

Alharbi M, Janssen S, Golpon H, Bremer M, Henkenberens C . Temporal and spatial dose distribution of radiation pneumonitis after concurrent radiochemotherapy in stage III non-small cell cancer patients. Radiat Oncol. 2017; 12(1):165. PMC: 5667443. DOI: 10.1186/s13014-017-0898-5. View

Mehta V . Radiation pneumonitis and pulmonary fibrosis in non-small-cell lung cancer: pulmonary function, prediction, and prevention. Int J Radiat Oncol Biol Phys. 2005; 63(1):5-24. DOI: 10.1016/j.ijrobp.2005.03.047. View

Ong C, Palma D, Verbakel W, Slotman B, Senan S . Treatment of large stage I-II lung tumors using stereotactic body radiotherapy (SBRT): planning considerations and early toxicity. Radiother Oncol. 2010; 97(3):431-6. DOI: 10.1016/j.radonc.2010.10.003. View

Mathew L, Gaede S, Wheatley A, Etemad-Rezai R, Rodrigues G, Parraga G . Detection of longitudinal lung structural and functional changes after diagnosis of radiation-induced lung injury using hyperpolarized 3He magnetic resonance imaging. Med Phys. 2010; 37(1):22-31. DOI: 10.1118/1.3263616. View

Palma D, Senan S, Tsujino K, Barriger R, Rengan R, Moreno M . Predicting radiation pneumonitis after chemoradiation therapy for lung cancer: an international individual patient data meta-analysis. Int J Radiat Oncol Biol Phys. 2012; 85(2):444-50. PMC: 3448004. DOI: 10.1016/j.ijrobp.2012.04.043. View

10.

Chun S, Hu C, Choy H, Komaki R, Timmerman R, Schild S . Impact of Intensity-Modulated Radiation Therapy Technique for Locally Advanced Non-Small-Cell Lung Cancer: A Secondary Analysis of the NRG Oncology RTOG 0617 Randomized Clinical Trial. J Clin Oncol. 2016; 35(1):56-62. PMC: 5455690. DOI: 10.1200/JCO.2016.69.1378. View

11.

Song C, Pyo H, Moon S, Kim T, Kim D, Cho K . Treatment-related pneumonitis and acute esophagitis in non-small-cell lung cancer patients treated with chemotherapy and helical tomotherapy. Int J Radiat Oncol Biol Phys. 2010; 78(3):651-8. DOI: 10.1016/j.ijrobp.2009.08.068. View