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Radiation pneumonitis in patients treated for malignant pulmonary lesions with hypofractionated radiation therapy.

Gerben R Borst ,
Masayori Ishikawa ,
Jasper Nijkamp ,
Michael Hauptmann ,
Hiroki Shirato ,
Rikiya Onimaru ,
Michel M van den Heuvel ,
Jose Belderbos ,
Joos V Lebesque ,
Jan-Jakob Sonke

Abstract

MATERIALS AND METHODS

For both SBRT (n=128) and CFRT (n=142) patients, RP grade > or = 2 was scored. Toxicity models predicting the probability of RP as a function of the MLD were fitted using maximum log likelihood analysis. The MLD was NTD (Normalized Total Dose) corrected using an alpha/beta ratio of 3 Gy.

CONCLUSION

We derived a significant dose-response relationship between the risk of RP and the MLD for SBRT from the clinical data. This relation was not significantly different from the dose-response relation for CFRT, although statistical analysis was hampered by the low number of patients in the high dose range.

RESULTS

SBRT patients were treated with 6-12 Gy per fraction with a median MLD of 6.4 Gy (range: 1.5-26.5 Gy). CFRT patients were treated with 2 Gy or 2.25 Gy per fraction, the median MLD was 13.2 Gy (range: 3.0-23.0 Gy). The crude incidence rates of RP were 10.9% and 17.6% for the SBRT and CFRT patients, respectively. A significant dose-response relationship for RP was found after SBRT, which was not significantly different from the dose-response relationship for CFRT (p=0.18).

PURPOSE

We evaluated the relationship between the mean lung dose (MLD) and the incidence of radiation pneumonitis (RP) after stereotactic body radiation therapy (SBRT), and compared this with conventional fractionated radiation therapy (CFRT).

More about this publication

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

Volume 91
Issue nr. 3
Pages 307-13
Publication date 01-06-2009

Full text links

Publisher website (DOI) 10.1016/j.radonc.2009.02.003
Europe PubMed Central 19321217
Pubmed 19321217

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