Radiation pneumonitis after stereotactic radiation therapy for lung cancer

来源 :World Journal of Radiology | 被引量 : 0次 | 上传用户:bingdaogege
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Stereotactic body radiation therapy(SBRT)has a locacontrol rate of 95%at 2 years for non-small cell lungcancer(NSCLC)and should improve the prognosis oinoperable patients,elderly patients,and patients withsignificant comorbidities who have early-stage NSCLCThe safety of SBRT is being confirmed in internationalmulti-institutional PhaseⅡtrials for peripheral lungcancer in both inoperable and operable patients,bureports so far have found that SBRT is a safe and effective treatment for early-stage NSCLC and early metastatic lung cancer.Radiation pneumonitis(RP)is oneof the most common toxicities of SBRT.Although mospost-treatment RP is Grade 1 or 2 and either asymptomatic or manageable,a few cases are severe,symptomatic,and there is a risk for mortality.The reportedrates of symptomatic RP after SBRT range from 9%to28%.Being able to predict the risk of RP after SBRT isextremely useful in treatment planning.A dose-effecrelationship has been demonstrated,but suggesteddose-volume factors like mean lung dose,lung V20and/or lung V2.5 differed among the reports.We foundthat patients who present with an interstitial pneumo-nitis shadow on computed tomography scan and high levels of serum Krebs von den Lungen-6 and surfactant protein D have a high rate of severe radiation pneumo-nitis after SBRT.At our institution,lung cancer patients with these risk factors have not received SBRT since 2006,and our rate of severe RP after SBRT has de-creased significantly since then. Stereotactic body radiation therapy (SBRT) has a locacontrol rate of 95% at 2 years for non-small cell lung cancer (NSCLC) and should improve the prognosis oinoperable patients, elderly patients, and patients with multiple coronary comorbidities who have early-stage NSCLC The safety of SBRT is being confirmed in international multi-institutional Phase II trials for peripheral lung cancer in both inoperable and operable patients, bureports so far have found that SBRT is a safe and effective treatment for early-stage NSCLC and early metastatic lung cancer. Radiation pneumonitis (RP) is one of the most common toxicities of SBRT. Although mospost-treatment RP is Grade 1 or 2 and either asymptomatic or manageable, a few cases are severe, symptomatic, and there is a risk for mortality. reported on of symptomatic RP after SBRT range from 9% to 28 % .Being able to predict the risk of RP after SBRT isextremely useful in treatment planning. A dose-effecrelationship has been demonstrated, but suggesteddose-volume factors lik e mean lung dose, lung V20 and / or lung V2.5 differed among the reports. We found that patients who present with an interstitial pneumo-nitis shadow on computed tomography scan and high levels of serum Krebs von den Lungen-6 and surfactant protein D a high rate of severe radiation pneumo-nitis after SBRT. At the institution, lung cancer patients with these risk factors have not received SBRT since 2006, and our rate of severe RP after SBRT has de-creased significantly since then.
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