容积剂量参数V20和V30在评估和预测同步放化疗治疗局部晚期非小细胞肺癌致放射性肺损伤中的应用

doi:10.13481/j.1671-587x.20150131

Abstract

Abstract:

Objective To research the relationship between volume dose(Vd)parameters V20 and V30 of dose volume histogram(DVH)and radioactive lung injury caused by concurrent radiochemotherapy in the treatment of locally advanced non-small cell lung cancer(LANSCLC), and to clear whether V30 and V20 could evaluate the probability of radioactive lung injury in chemoradiation. Methods 36 patients treated with concurrent radiochemotherapy were retrospectively analyzed.Radiotherapy Ways : 3D-CRT, the conventional fractionation was 2 Gy/frack(F), 5 times/week, the total dose in concurrent chemoradiotherapy group was 66-70 Gy/30-33 F and the total dose in sequential chemoradiotherapy group was 60-70Gy/30-35F.Chemotherapy plan: Taxol 135 mg·m^-2 at the 1st and 22nd days, Carboplatin AUC=6 g·L^-1·min^-1, at the 1st and 22nd days.The correlation analysis between the grade of level 2 or higher incidence of radioactive lung injury and DVH parameters(V30 and V20)was performed.And according to the whole lung average V30(18.17%)and V20(25.32%), the groups were set up: V30 ≤18%, V30>18% and V20≤25%, V20>25%, and the incidence of levels 2 or higher radioactive lung injury in each group was compared. Results There has positive correlation between levels 2 or higher lung injury classification and V20, V30(r=0.705, P<0.05;r=0.740, P<0.05);the incidence of levels 2 or higher lung injury was respectively 16.67% and 55.56% in V30 ≤ 18.00% group and V30>18.00% group, and there was significant difference(P<0.05);the incidence of levels 2 or higher lung injury was respectively 17.64% and 52.63% in V20 ≤25% and V20 > 25% groups, and there was significant difference(P<0.05). Conclusion V30 and V20 can be used to evaluate and forecast the incidence of radioactive lung injury;when V30>18% and V20>25%, the incidence of radioactive lung injury is significantly increased, and the treatment plan needs to be modified and even the design of treatment plan is given up.

Key words: cancer, non small cell lung, concurrent radiochemotherapy, radioactive lung injury, volume dose parameters

CLC Number:

R734.2

DU Minjuan, JIANG Zhenyu, XU Xiaoguang, LI Jie, ZHANG Jin. Application of V20 and V30 volume dose parameters in evaluating and forecasting radioactive lung injury caused by concurrent radiochemotherapy in treatment of locally advanced non-small cell lung cancer[J].Journal of Jilin University Medicine Edition, 2015, 41(01): 160-164.

References

[1] 杨新华,钟兰俊,李延特,等. 紫杉醇和顺铂加放疗同步治疗Ⅲ期非小细胞肺癌临床观察 [J].中国肿瘤临床与康复,2007,12(12):163-165.

[2] 仇晓军,马剑波,季斌,等.康莱特加同步放化疗治疗局部晚期非小细胞肺癌的临床研究 [J].临床肿瘤学杂志,2007,12(2):131-133.

[3] Trotti A,Colevas AD,Setser A,et al.CTCAE v3.0: development of a comprehensive grading system for the adverse effects of cancer treatment [J].Semin Radiat Oncol,2003,13(3):176-181.

[4] Rodrigues G,Lock M,D'Souza D,et al.Prediction of radiation pneumonitis by dose-volume histogram parameters in lung cancer-a systematic review [J].Radiother Oncol,2004,71(2):127-138.

[5] Willner J,Jost A, Baier K, et al.A little to a lot or a lot to a little? An analysis of pneumonitis risk from dose-volume histogram parameters of the lung in patients with lung cancer treated with 3-D conformal radiotherapy [J].Strahlenther Onkol,2003,179(8):548-566.

[6] Tang C,Gomez DR,Wang H,et al.Association between white blood cell count following radiation therapy with radiation pneumonitis in non-small cell lung cancer [J].Int J Radiat Oncol Biol Phys,2014,88(2):319-325.

[7] Wang D, Zhu J,Sun J,et al.Functional and biologic metrics for predicting radiation pneumonitis in locally advanced non-small cell lung cancer patients treated with chemoradiotherapy [J].Clin Transl Oncol,2012,14(12):943-952.

[8] Farr KP,Khalil AA,Knap MM,et al.Development of radiation pneumopathy and generalised radiological changes after radiotherapy are independent negative prognostic factors for survival in non-small cell lung cancer patients [J].Radiother Oncol,2013,107(3):382-388.

[9] Liu Y, Xia T, Zhang W,et al.Variations of circulating endothelial progenitor cells and transforming growth factor-beta-1 (TGF-β1) during thoracic radiotherapy are predictive for radiation pneumonitis [J]. Radiat Oncol,2013,8(1):189-197.

[10] Piotrowski T,Matecka-Nowak M,Milecki P.Prediction of radiation pneumonitis: dose-volume histogram analysis in 62 patients with non-small cell lung cancer after three-dimensional conformal radiotherapy [J]. Neoplasma,2005,52(1):56-62.

[11] Agrawal S,Kumar S,Lawrence A,et al.Ipsilateral lung dose volume parameters predict radiation pneumonitis in addition to classical dose volume parameters in locally advanced NSCLC treated with combined modality therapy [J].South Asian J Cancer,2014,3(1):13-15.

[12] Appalanaido GK,Arul E,Choung WL.Meta-analysis of incidence of early lung toxicity in 3-dimensional conformal irradiation of breast carcinomas [J].Radiat Oncol,2013,8(1):268-279.

[13] Nomura M,Kodaira T,Furutani K,et al.Predictive factors for radiation pneumonitis in oesophageal cancer patients treated with chemoradiotherapy without prophylactic nodal irradiation [J].Br J Radiol,2012,85(1014):813-818.

[14] Kim B,Park HC,Oh D,et al.Development of the DVH management software for the biologically-guided evaluation of radiotherapy plan [J].Radiat Oncol J,2012,30(1):43-48.

[15] Uno T,Isobe K,Kawakami H,et al.Dose-volume factors predicting radiation pneumonitis in patients receiving salvage radiotherapy for postlobectomy locoregional recurrent non-small-cell lung cancer [J].Int J Clin Oncol,2006,11(1):55-59.

[16] Barriger RB,Forquer JA,Brabham JG,et al.A dose-volume analysis of radiation pneumonitis in non-small cell lung cancer patients treated with stereotactic body radiation therapy [J].Int J Radiat Oncol Biol Phys,2012,82(1):457-462.

[17] 王澜,高超,韩春,等.DVH参数对局部晚期非小细胞肺癌同期化放疗肺损伤的预测价值研究 [J].中华放射医学与防护杂志,2010,30(6):725-727.

[18] 杨阳,闫婧,刘娟,等.胸部放疗放射性肺炎病因学相关因素分析 [J].中华肿瘤防治杂志,2012,19(6): 446-449.

[19] Wang D,Shi J,Liang S,et al.Dose-volume histogram parameters for predicting radiation pneumonitis using receiver operating characteristic curve [J].Clin Transl Oncol,2013,15(5):364-369.

[20] Hoover DA,Reid RH,Wong E,et al.SPECT-based functional lung imaging for the prediction of radiation pneumonitis: a clinical and dosimetric correlation [J].J Med Imaging Radiat Oncol,2014,58(2):214-222.

Application of V20 and V30 volume dose parameters in evaluating and forecasting radioactive lung injury caused by concurrent radiochemotherapy in treatment of locally advanced non-small cell lung cancer

PDF (PC)

Like

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Metrics

Comments

Recommended 0

[1]	LI Lijing, ZANG Yaru, YU Wenhui, LIANG Junwei, TONG Yanjun. Therapeutic effect of chemotherapy combined with sodium cantharidinate vitamin B6 injection in patientswith non-small cell lung cancer and its mechanism [J]. Journal of Jilin University(Medicine Edition), 2018, 44(06): 1286-1290.
[2]	SUN Hongshuai, ZHU Hua, GAO Haiyan, WAN Guangcai, YU Xiuyan. Value of combined detection of tumor markers SCC-Ag, CEA, CYFRA21-1 and D-dimer in early diagnosis of non-small cell lung cancer [J]. Journal of Jilin University(Medicine Edition), 2018, 44(05): 1020-1024.
[3]	. Research progress in relationships between polymorphisms of DNA damage repair pathway gene and sensitivity and prognosis of non-small cell lung cancer treated with platinum drugs [J]. Journal of Jilin University Medicine Edition, 2018, 44(04): 869-874.
[4]	QUAN Xiaoyue, LIU Bailong, LIU Min, DONG Lihua. Treatment of lung squamous cell carcinoma with apatinib in patient who couldn't tolerate chemotherapy: A case report and literature review [J]. Journal of Jilin University Medicine Edition, 2018, 44(03): 624-627.
[5]	. Research progress in thoracic radiotherapy in limited-disease small cell lung cancer [J]. Journal of Jilin University Medicine Edition, 2018, 44(01): 190-194.
[6]	LIU Xiangliang, JI Wei, LI Li, ZHAO Yinghua, JIA Lin, WANG Zhiqiang, CHEN Xiao, LI Wei. Lung adenocarcinoma treated by Erlotinib HCL Tablets and chemotherapy combined with bevacizumab after drug resistance:A case report and literature review [J]. Journal of Jilin University Medicine Edition, 2017, 43(05): 1019-1024.
[7]	LIU Danqing, YE Shufeng, TONG Weifang, TENG Bo, WANG Sanchun, FENG Qingjie. Renal clear cell carcinoma transferred to nasal cavity and sinuses:A case reportand literature review [J]. Journal of Jilin University Medicine Edition, 2017, 43(04): 829-831.
[8]	. Progress research on effect of long non-coding RNA in occurrence and development of lung cancer [J]. Journal of Jilin University Medicine Edition, 2017, 43(02): 450-453.
[9]	XI Yanli, XU Na, LI Shu, WANG Di, WANG Shuran, NIU Fenglan. Inhibitory effect of gallic acid on proliferation of human non-small cell lung cancer A549 cells [J]. Journal of Jilin University Medicine Edition, 2016, 42(06): 1092-1098.
[10]	. Progress research on mechanism of FGFR signaling pathway in pathogenesis of IPF and non-small cell lung cancer [J]. Journal of Jilin University Medicine Edition, 2016, 42(06): 1254-1258.
[11]	LI Xingxing, TAN Jingjin, JIANG Shan, WAHG Ke. Role of let-7 and HMGA2 in occurrence and development of lung cancer: Meta-analysis [J]. Journal of Jilin University Medicine Edition, 2016, 42(06): 1116-1125.
[12]	YUN Fen, JIA Yongfeng, HAN Zhao, SUN Qinnuan, LI Xiuxia, YU Huiling. Expression of HIF-2αin non-small cell lung cancer tissue and its relationships with MVD,Ki67,and GST-π [J]. Journal of Jilin University Medicine Edition, 2016, 42(05): 954-957.
[13]	LIU Huanxin, ZHANG Guoxiang, GUO Linlang, TAN Songshan. Expression of miR-139-5p in small cell lung cancer tissue and its clinical significance [J]. Journal of Jilin University Medicine Edition, 2016, 42(05): 942-948.
[14]	LI Shimeng, PAN Baoxiang, LI Tong, XIE Feng, WANG Hai. Correlation between expression of programmed cell death-ligand 1 protein and prognosis of lung cancer:A Meta-analysis [J]. Journal of Jilin University Medicine Edition, 2015, 41(05): 969-973.
[15]	LIN Xing-yu,YANG Zhi-guang,ZHANG Peng,SHAO Guo-guang. Comparison of curative effects of lobectomy between C-VATS  and thoracotomy in aged patients with lung cancer  [J]. Journal of Jilin University Medicine Edition, 2014, 40(06): 1275-1279.