Abstract
BACKGROUND: Symptomatic radiation pneumonitis (RP) may be a serious complication after thoracic radiation therapy (RT) for non-small cell lung cancer (NSCLC). This prospective observational study sought to evaluate the utility of a novel radiation-induced lung injury (RILI) grading scale (RGS) for the prediction of RP.
MATERIALS AND METHODS: Data of 41 patients with NSCLC treated with thoracic RT of 60-66 Gy were analysed. CT scans were scheduled before RT, one month post-RT, and every three months thereafter for one year. Symptomatic RP was defined as Common Terminology Criteria for Adverse Events grade ≥ 2. RGS grading ranged from 0 to 3. The inter-observer variability of the RGS was assessed by four senior radiologists. CT scans performed 28 ± 10 days after RT were used to analyse the predictive value of the RGS. The change in the RGS severity was correlated to dosimetric parameters.
RESULTS: The CT obtained one month post-RT showed RILI in 36 (88%) of patients (RGS grade 0 [5 patients], 1 [25 patients], 2 [6 patients], and 3 [5 patients]). The inter-observer agreement of the RGS grading was high (Kendall's W coefficient of concordance = 0.80, p < 0.01). Patients with RGS grades 2-3 had a significantly higher risk for development of RP (relative risk (RR): 2.4, 95% CI 1.6-3.7, p < 0.01) and RP symptoms within 8 weeks after RT (RR: 4.8, 95% CI 1.3-17.6, p < 0.01) compared to RGS grades 0-1. The specificity and sensitivity of the RGS grades 2-3 in predicting symptomatic RP was 100% (95% CI 80.5-100%) and 45.4% (95% CI 24.4-67.8%), respectively. Increase in RGS severity correlated to mean lung dose and the percentage of the total lung volume receiving 5 Gy.
CONCLUSIONS: The RGS is a simple radiologic tool associated with symptomatic RP. A validation study is warranted.
Original language | English |
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Article number | 131 |
Journal | Radiation Oncology |
Volume | 16 |
Issue number | 1 |
DOIs | |
Publication status | Published - 15 Jul 2021 |
Bibliographical note
© 2021. The Author(s).Keywords
- Non-small cell lung cancer radiation therapy
- Radiation pneumonitis
- Radiation therapy toxicity
- Radiation-induced lung injury
- Radiation-related pulmonary toxicity
- Radiological radiation-induced lung injury scale
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Additional file 2 of High-dose thoracic radiation therapy for non-small cell lung cancer: a novel grading scale of radiation-induced lung injury for symptomatic radiation pneumonitis
Szejniuk, W. M. (Creator), Nielsen, M. S. (Creator), Takács-Szabó, Z. (Creator), Pawlowski, J. (Creator), Al-Saadi, S. S. (Creator), Maidas, P. (Creator), Bøgsted, M. (Creator), McCulloch, T. (Creator), Frøkjær, J. B. (Creator), Falkmer, U. G. I. (Creator) & Røe, O. D. (Creator), Figshare, 2021
DOI: 10.6084/m9.figshare.14992802.v1, https://doi.org/10.6084%2Fm9.figshare.14992802.v1
Dataset
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High-dose thoracic radiation therapy for non-small cell lung cancer: a novel grading scale of radiation-induced lung injury for symptomatic radiation pneumonitis
Szejniuk, W. M. (Creator), Nielsen, M. S. (Creator), Takacs-Szabó, Z. (Creator), Pawlowski, J. (Creator), Al-Saadi, S. S. (Creator), Maidas, P. (Creator), Bøgsted, M. (Creator), McCulloch, T. (Creator), Frøkjær, J. B. (Creator), Falkmer, U. G. I. (Creator) & Røe, O. D. (Creator), Figshare, 2021
DOI: 10.6084/m9.figshare.c.5514821, https://springernature.figshare.com/collections/High-dose_thoracic_radiation_therapy_for_non-small_cell_lung_cancer_a_novel_grading_scale_of_radiation-induced_lung_injury_for_symptomatic_radiation_pneumonitis/5514821
Dataset
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Additional file 1 of High-dose thoracic radiation therapy for non-small cell lung cancer: a novel grading scale of radiation-induced lung injury for symptomatic radiation pneumonitis
Szejniuk, W. M. (Creator), Nielsen, M. S. (Creator), Takács-Szabó, Z. (Creator), Pawlowski, J. (Creator), Al-Saadi, S. S. (Creator), Maidas, P. (Creator), Bøgsted, M. (Creator), McCulloch, T. (Creator), Frøkjær, J. B. (Creator), Falkmer, U. G. I. (Creator) & Røe, O. D. (Creator), Figshare, 2021
DOI: 10.6084/m9.figshare.14992799.v1, https://doi.org/10.6084%2Fm9.figshare.14992799.v1
Dataset