1 / 4

Evaluating a Nomogram for Radiation Pneumonitis in NSCLC Treated with 3D and IMRT

This study aims to evaluate a previously published nomogram for predicting the risk of radiation pneumonitis (RP) in locally advanced non-small cell lung cancer (NSCLC) treated with 3D and intensity modulated radiation therapy (IMRT). The study collected clinical, tumor, and dosimetric information from 340 patients treated at Siteman Cancer Center. Factors predictive of grade 2 or higher RP were determined using univariate and multivariate analyses. The results validate the dose to the heart as a predictive factor for RP and support the use of the nomogram for patients treated with 3DCRT.

narnold
Download Presentation

Evaluating a Nomogram for Radiation Pneumonitis in NSCLC Treated with 3D and IMRT

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Evaluating a Nomogram for the Development of Radiation Pneumonitis in Locally Advanced Non-Small Cell Lung Cancer Treated with 3D and Intensity Modulated Radiation Therapy Sana Rehman, MD1, Christina K. Speirs, MD, PhD1, Alerson Molotievschi, MD2, Daniel Mullen, DDS, MS1, Sandra Fergus BS1, Todd A. DeWees, PhD1, Maria A. Velez1, Jeffrey D. Bradley, MD1, Cliff G. Robinson, MD1, 1Washington University in St. Louis, St. Louis, MO,  2Barretos Cancer Hospital, Barretos, Brazil Session title: Lung 1 – Novel Prognostic Factors and SBRT ASTRO 2014 - #57012

  2. Purpose / Methods • Purpose • Evaluate a previously published nomogram on risk of developing radiation pneumonitis (RP) on a more modern cohort, including patients treated with intensity modulated radiation therapy (IMRT) • Determine risk factors for development of grade 2 or higher RP • Methods • Retrospective analysis of 340 patients treated with radiation therapy for locally advanced non-small cell lung cancer at Siteman Cancer Center from 2001 to 2012. • Clinical, tumor, and dosimetric information were collected. • Univariate (UVA) and multivariate (MVA) analyses were used to correlate these factors with the development of ≥ grade 2 RP. • RP risk was determined based on a nomogram prediction for RP. Spearman’s rank correlation was performed based on the calculated risk of RP versus the actual rate of RP.

  3. Results • 111 patients (35%) developed grade 2 or higher RP at a median of 3.6 months (range, 0 – 21.9 mo). • Factors predictive on UVA for grade 2 or higher RP included: • Use of adjuvant chemotherapy • Former smoking status • Heart mean dose • Heart V5-55 Gy (in 5 Gy increments) • Total lung volume minus PTV V35-50 Gy (in 5 Gy increments) • RP risk nomogram score • On MVA, heart V35 Gy was predictive and current smoking status was protective of grade 2 or higher RP.

  4. Conclusion • The dose to the heart is predictive for the risk of RP. • The nomogram for predicting RP is validated for patients treated with 3DCRT. • The nomogram was not validated for patients treated with IMRT.

More Related