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Radiother Oncol. 2017 Apr;123(1):93-98. doi: 10.1016/j.radonc.2017.02.001. Epub 2017 Mar 1.

Extent and computed tomography appearance of early radiation induced lung injury for non-small cell lung cancer.

Author information

1
Institute of Clinical Research, University of Southern Denmark, Odense, Denmark; Laboratory of Radiation Physics, Odense University Hospital, Odense, Denmark. Electronic address: uffe.bernchou@rsyd.dk.
2
Laboratory of Radiation Physics, Odense University Hospital, Odense, Denmark.
3
Department of Radiology, Odense University Hospital, Odense, Denmark.
4
Department of Oncology, Odense University Hospital, Odense, Denmark.
5
Institute of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Oncology, Odense University Hospital, Odense, Denmark.
6
Institute of Clinical Research, University of Southern Denmark, Odense, Denmark; Laboratory of Radiation Physics, Odense University Hospital, Odense, Denmark.

Abstract

BACKGROUND AND PURPOSE:

The present study investigates the extent and appearance of radiologic injury in the lung after radiotherapy for non-small cell lung cancer (NSCLC) patients and correlates radiologic response with clinical and dosimetric factors.

METHODS AND MATERIALS:

Eligible follow-up CT scans acquired up to six months after radiotherapy were evaluated for radiologic injuries in 220 NSCLC patients. Radiologic injuries were divided into three categories: (1) interstitial changes, (2) ground-glass opacity, or (3) consolidation. The relationship between the fraction of injured lung of each category and clinical or dosimetric factors was investigated.

RESULTS:

Radiological injuries of category 1-3 were found in 67%, 52%, and 51% of the patients, and the mean (and maximum) fraction of injured lung was 4.4% (85.9%), 2.4% (46.0%), and 2.1% (22.9%), respectively. Traditional lung dose metrics and time to follow-up predicted lung injury of all categories. Older age increased the risk of interstitial changes and current smoking reduced the risk of consolidation in the lung.

CONCLUSION:

Radiologic injuries were frequently found in follow-up CT scans after radiotherapy for NSCLC patients. The risk of a radiologic response increased with increasing time and lung dose metrics, and depended on patient age and smoking status.

KEYWORDS:

Computed tomography appearance; Lung cancer; Radiologic lung injury; Response modelling

PMID:
28259449
DOI:
10.1016/j.radonc.2017.02.001
[Indexed for MEDLINE]

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