Pulmonary function decreases moderately after accelerated high-dose irradiation for stage III non-small cell lung cancer.
DLCO
FEV1
NSCLC
minimal clinically important difference (MCID)
radiotherapy
Journal
Thoracic cancer
ISSN: 1759-7714
Titre abrégé: Thorac Cancer
Pays: Singapore
ID NLM: 101531441
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
received:
02
10
2019
revised:
21
11
2019
accepted:
23
11
2019
pubmed:
20
12
2019
medline:
6
3
2021
entrez:
20
12
2019
Statut:
ppublish
Résumé
Chemoradiotherapy (CRT) is the standard treatment for patients with inoperable stage III non-small cell lung cancer (NSCLC) stage III. With a median OS beyond 30 months, adequate pulmonary function (PF) is essential to ensure acceptable quality of life after treatment. Forced expiratory volume in 1 second (FEV1) and diffusing capacity of the lung for carbon monoxide (DLCO) are the most widely used parameters to assess lung function. The aim of the current study was to evaluate dose-volume effects of accelerated high-dose radiation on PF. A total of 72 patients were eligible for the current analysis. After induction chemotherapy, all patients received dose-differentiated accelerated radiotherapy with intensity-modulated radiotherapy (IMRT-DART). PF tests were performed six weeks, three and six months after the end of radiotherapy. The median total dose to the tumor was 73.8 Gy (1.8 Gy bid) with a size dependent range between 61.2 and 90 Gy. In the whole cohort, 321 pulmonary function tests were performed. At six months, the median FEV1 relative to baseline was 0.95 (range: 0.56-1.36), and the relative median DLCO decreased to 0.98 (range: 0.64-1.50). The correlation between V20 Patients with a V20 Significant findings: Pulmonary function after high dose irradiation decreases only moderately. FEV1 and DLCO decrease depend on V20 This study shows that high-dose irradiation delivered with intensity-modulated techniques does not impair short-term lung function even in patients with compromised respiratory capacity before treatment. This is a pre-requisite for adequate quality of life after thoraco-oncological therapy.
Sections du résumé
BACKGROUND
Chemoradiotherapy (CRT) is the standard treatment for patients with inoperable stage III non-small cell lung cancer (NSCLC) stage III. With a median OS beyond 30 months, adequate pulmonary function (PF) is essential to ensure acceptable quality of life after treatment. Forced expiratory volume in 1 second (FEV1) and diffusing capacity of the lung for carbon monoxide (DLCO) are the most widely used parameters to assess lung function. The aim of the current study was to evaluate dose-volume effects of accelerated high-dose radiation on PF.
METHODS
A total of 72 patients were eligible for the current analysis. After induction chemotherapy, all patients received dose-differentiated accelerated radiotherapy with intensity-modulated radiotherapy (IMRT-DART). PF tests were performed six weeks, three and six months after the end of radiotherapy.
RESULTS
The median total dose to the tumor was 73.8 Gy (1.8 Gy bid) with a size dependent range between 61.2 and 90 Gy. In the whole cohort, 321 pulmonary function tests were performed. At six months, the median FEV1 relative to baseline was 0.95 (range: 0.56-1.36), and the relative median DLCO decreased to 0.98 (range: 0.64-1.50). The correlation between V20
CONCLUSION
Patients with a V20
KEY POINTS
Significant findings: Pulmonary function after high dose irradiation decreases only moderately. FEV1 and DLCO decrease depend on V20
WHAT THIS STUDY ADDS
This study shows that high-dose irradiation delivered with intensity-modulated techniques does not impair short-term lung function even in patients with compromised respiratory capacity before treatment. This is a pre-requisite for adequate quality of life after thoraco-oncological therapy.
Identifiants
pubmed: 31855325
doi: 10.1111/1759-7714.13276
pmc: PMC6996983
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
369-378Informations de copyright
© 2019 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.
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