Stereotactic body radiation therapy for patients with pulmonary interstitial change: High incidence of fatal radiation pneumonitis in a retrospective multi-institutional study

Hiroshi Onishi, Hideomi Yamashita, Yoshiyuki Shioyama, Yasuo Matsumoto, Kenji Takayama, Yukinori Matsuo, Akifumi Miyakawa, Haruo Matsushita, Masahiko Aoki, Keiji Nihei, Tomoki Kimura, Hiromichi Ishiyama, Naoya Murakami, Kensei Nakata, Atsuya Takeda, Takashi Uno, Takuma Nomiya, Tuyoshi Takanaka, Yuji Seo, Takafumi KomiyamaKan Marino, Shinichi Aoki, Ryo Saito, Masayuki Araya, Yoshiyasu Maehata, Licht Tominaga, Kengo Kuriyama

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3 Citations (Scopus)

Abstract

Pretreatment pulmonary interstitial change (PIC) has been indicated as a risk factor of severe radiation pneumonitis (RP) following stereotactic body radiation therapy (SBRT) for early-stage lung cancer, but details of its true effect remain unclear. This study aims to evaluate treatment outcomes of SBRT for stage I non-small cell lung cancer in patients with PIC. A total of 242 patients are included in this study (88% male). The median age is 77 years (range, 55–92 years). A total dose of 40–70 Gy is administered in 4 to 10 fractions during a 4-to-25 day period. One, two, and three-year overall survival (OS) rates are 82.1%, 57.1%, and 42.6%, respectively. Fatal RP is identified in 6.9% of all patients. The percent vital capacity <70%, mean percentage normal lung volume receiving more than 20 Gy (>10%), performance status of 2–4, presence of squamous cell carcinoma, clinical T2 stage, regular use of steroid before SBRT, and percentage predicting forced expiratory volume in one second (<70%) are associated with worse prognoses for OS. Our results indicate that fatal RP frequently occurs after SBRT for stage I lung cancer in patients with PIC.

Original languageEnglish
Article number257
JournalCancers
Volume10
Issue number8
DOIs
Publication statusPublished - Aug 2018

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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    Onishi, H., Yamashita, H., Shioyama, Y., Matsumoto, Y., Takayama, K., Matsuo, Y., Miyakawa, A., Matsushita, H., Aoki, M., Nihei, K., Kimura, T., Ishiyama, H., Murakami, N., Nakata, K., Takeda, A., Uno, T., Nomiya, T., Takanaka, T., Seo, Y., ... Kuriyama, K. (2018). Stereotactic body radiation therapy for patients with pulmonary interstitial change: High incidence of fatal radiation pneumonitis in a retrospective multi-institutional study. Cancers, 10(8), [257]. https://doi.org/10.3390/cancers10080257