RISS 검색 - 국내학술지논문 상세보기

다국어 초록 (Multilingual Abstract)

Purpose: Thoracic radiotherapy is a major treatment modality of stage III non-small cell lung cancer. The normal lung tissue is sensitive to radiation and radiation pneumonitis is the most important dose-limiting complication of thoracic radiation therapy.
This study was performed to identify the clinical and dosimetric parameters related to the risk of radiation pneumonitis after defi nitive radiotherapy in stage III non-small cell cancer patients.
Materials and Methods: The medical records were reviewed for 49 patients who completed defi nitive radiation therapy for locally advanced non-small cell lung cancer from August 2000 to February 2010. Radiation therapy was delivered with the daily dose of 1.8 Gy to 2.0 Gy and the total radiation dose ranged from 50.0 Gy to 70.2 Gy (median, 61.2 Gy). Elective nodal irradiation was delivered at a dose of 45.0 Gy to 50.0 Gy. Seven patients (14.3%) were treated with radiation therapy alone and forty two patients (85.7%) were treated with chemotherapy either sequentially or concurrently.
Results: Twenty-fi ve cases (51.0%) out of 49 cases experienced radiation pneumonitis. According to the radiation pneumonitis grade, 10 (20.4%) were grade 1, 9 (18.4%) were grade 2, 4 (8.2%) were grade 3, and 2 (4.1%) were grade 4. In the univariate analyses, no clinical factors including age, sex, performance status, smoking history, underlying lung disease, tumor location,total radiation dose and chemotherapy were associated with grade ≥2 radiation pneumonitis. In the subgroup analysis of the chemotherapy group, concurrent rather than sequential chemotherapy was signifi cantly related to grade ≥2 radiation pneumonitis comparing sequential chemotherapy. In the univariate analysis with dosimetric factors, mean lung dose (MLD), V20, V30, V40, MLDipsi,V20ipsi, V30ipsi, and V40ipsi were associated with grade ≥2 radiation pneumonitis. In addition, multivariate analysis showed that MLD and V30 were independent predicting factors for grade ≥2 radiation pneumonitis.
Conclusion: Concurrent chemotherapy, MLD and V30 were statistically signifi cant predictors of grade ≥2 radiation pneumonitis in patients with stage III non-small cell lung cancer undergoing defi nitive radiotherapy. The cutoff values for MLD and V30 were 16 Gy and 18%, respectively.

참고문헌 (Reference)

1 김명세, "세기조절방사선치료(IMRT)로 치료한 비소세포폐암 환자에서의 방사선 폐렴" 대한방사선종양학회 26 (26): 35-44, 2008

2 Yuan S, "randomized study of involved-fi eld irradiation versus elective nodal irradiation in combination with concurrent chemotherapy for inoperable stage III nonsmall cell lung cancer" 30 : 239-244, 2007

3 Ministry for Health, Welfare and Family Affairs. Annual report of cancer incidence, "cancer prevalence (2007) and survival (1993-2007) in Korea" Welfare and Family Affairs 2007

4 Emami B, "Tolerance of normal tissue to therapeutic irradiation" 21 : 109-122, 1991

5 Morton RF, "Thoracic radiation therapy alone compared with combined chemoradiotherapy for locally unresectable non-small cell lung cancer: a randomized, phase III trial" 115 : 681-686, 1991

6 Yamada M, "Risk factors of pneumonitis following chemoradiotherapy for lung cancer" 34 : 71-75, 1998

7 Segawa Y, "Risk factors for development of radiation pneumonitis following radiation therapy with or without chemotherapy for lung cancer" 39 : 91-98, 1997

8 Byhardt RW, "Response, toxicity, failure patterns, and survival in five Radiation Therapy Oncology Group (RTOG) trials of sequential and/or concurrent chemotherapy and radiotherapy for locally advanced nonsmall- cell carcinoma of the lung" 42 : 469-478, 1998

9 Seppenwoolde Y, "Regional differences in lung radiosensitivity after radiotherapy for non-small-cell lung cancer" 60 : 748-758, 2004

10 Antonadou D, "Randomized phase III trial of radiation treatment +/- amifostine in patients with advanced-stage lung cancer" 51 : 915-922, 2001