Tuberc Respir Dis.  2004 Jan;56(1):40-50.

Factors Predicting the Development of Radiation Pneumonitis in the Patients Receiving Radiation Therapy for Lung Cancer

• An JY
• Kwon SJ
• Lee YS
• Park HS
• Jung SS
• Kim JW
• Kim JO
• Jo MJ
• Kim SY

Abstract

BACKGROUND: Radiation pneumonitis(RP) is the major serious complication of thoracic irradiation treatment. In this study, we attempted to retrospectively evaluate the long-term prognosis of patients who experienced acute RP and to identify factor that might allow prediction of RP.
METHODS
Of the 114 lung cancer patients who underwent thoracic radiotherapy between December 2000 and December 2002, We performed analysis using a database of 90 patients who were capable of being evaluated.
RESULTS
Of the 44 patients(48.9%) who experienced clinical RP in this study, the RP was mild in 33(36.6%) and severe in 11(12.3%). All of severe RP were treated with corticosteroids. The median starting corticosteroids dose was 34 mg(30~40) and median treatment duration was 68 days(8~97). The median survival time of the 11 patients who experienced severe RP was significantly poorer than the mild RP group. (p=0.046) The higher total radiation dose(>or=60 Gy) was significantly associated with developing in RP.(p=0.001) The incidence of RP did not correlate with any of the ECOG performance, pulmonary function test, age, cell type, history of smoking, radiotherapy combined with chemotherapy, once-daily radiotherapy dose fraction. Also, serum albumin level, uric acid level at onset of RP did not influence the risk of severe RP in our study.
CONCLUSION
Only the higher total radiation dose(>or=60 Gy) was a significant risk factor predictive of RP. Also severe RP was an adverse prognostic factor.

Keyword

Radiation pneumonitis; Lung cancer

MeSH Terms

Adrenal Cortex Hormones
Drug Therapy
Humans
Incidence
Lung Neoplasms*
Lung*
Prognosis
Radiation Pneumonitis*
Radiotherapy
Respiratory Function Tests
Retrospective Studies
Risk Factors
Serum Albumin
Smoke
Smoking
Uric Acid
Adrenal Cortex Hormones
Serum Albumin
Smoke
Uric Acid