| Computed Tomography Appearance of Early Radiation Injury to the Lung: Correlation with Clinical and Dosimetric Factors. | |
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MedLine Citation:
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PMID: 21543163 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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PURPOSE: To systematically assess the spectrum of radiologic changes in the lung after radiation therapy for non-small-cell lung cancer. METHODS AND MATERIALS: We reviewed the cases of 146 patients treated with radical radiotherapy at our institution. All patients had computed tomography (CT) scans performed 3 months after completion of therapy. Radiographic appearances were categorized using a standard grading system. The association of these abnormalities with pretreatment factors and clinical radiation pneumonitis (RP) was investigated. RESULTS: New intrapulmonary abnormalities were seen in 92 patients (63%). These were ground-glass opacity in 16 (11%), patchy consolidation in 19 (13%), and diffuse consolidation in 57 (39%). Twenty-five patients (17%) developed clinical symptoms of RP. Although 80% of the patients with RP had areas of consolidation seen on the posttreatment CT scan, the majority (74%) of patients with such radiographic changes were asymptomatic. For patients with lung infiltrates, the minimum isodose encompassing the volume of radiologic abnormality was usually ≥27 Gy. Traditional dose-volume metrics, pulmonary function tests, and the coadministration of angiotensin converting enzyme inhibitors (ACE-I) were all strongly correlated with the presence of radiologic injury on univariate analysis (p ≤ 0.002). There was also an inverse correlation between prior smoking history and CT scan changes (p = 0.02). On multivariate analysis, dosimetric parameters and the use of ACE-I retained significance (p = 0.005). CONCLUSIONS: Our findings suggest that there is substantial interindividual variation in lung radiosensitivity. ACE-I prevented the radiologic changes seen after high-dose radiation therapy, and their role as radioprotectants warrants further investigation. |
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Authors:
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Peter Jenkins; Anne Welsh |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-5-3 |
Journal Detail:
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Title: International journal of radiation oncology, biology, physics Volume: - ISSN: 1879-355X ISO Abbreviation: - Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-5-5 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7603616 Medline TA: Int J Radiat Oncol Biol Phys Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Gloucestershire Oncology Centre, Cheltenham General Hospital, Cheltenham, UK. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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