TY - JOUR
T1 - Heart irradiation as a risk factor for radiation pneumonitis
AU - Huang, Ellen X.
AU - Hope, Andrew J.
AU - Lindsay, Patricia E.
AU - Trovo, Marco
AU - El Naqa, Issam
AU - Deasy, Joseph O.
AU - Bradley, Jeffrey D.
N1 - Funding Information:
This research was supported by NIH grant R01 CA85181. These results were originally reported at the 50 th ASTRO meeting, September 21 – 25, 2008. The authors declare that there are no potential conflicts of interest associated with this work.
PY - 2011/1
Y1 - 2011/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=78650574832&partnerID=8YFLogxK
U2 - 10.3109/0284186X.2010.521192
DO - 10.3109/0284186X.2010.521192
M3 - Article
C2 - 20874426
AN - SCOPUS:78650574832
SN - 0284-186X
VL - 50
SP - 51
EP - 60
JO - Acta Oncologica
JF - Acta Oncologica
IS - 1
ER -