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Titolo:
PHYSICAL AND BIOLOGICAL PREDICTORS OF CHANGES IN WHOLE-LUNG FUNCTION FOLLOWING THORACIC IRRADIATION
Autore:
MARKS LB; MUNLEY MT; BENTEL GC; ZHOU SM; HOLLIS D; SCARFONE C; SIBLEY GS; KONG FM; JIRTLE R; JASZCZAK R; COLEMAN RE; TAPSON V; ANSCHER M;
Indirizzi:
DUKE UNIV,MED CTR,DEPT RADIAT ONCOL,BOX 3085 DURHAM NC 27710 DUKE UNIV,MED CTR,DEPT RADIOL DURHAM NC 27710 DUKE UNIV,MED CTR,DEPT PULM MED DURHAM NC 27710
Titolo Testata:
International journal of radiation oncology, biology, physics
fascicolo: 3, volume: 39, anno: 1997,
pagine: 563 - 570
SICI:
0360-3016(1997)39:3<563:PABPOC>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
DOSE-VOLUME HISTOGRAM; PULMONARY-FUNCTION; HODGKINS-DISEASE; COMPLICATION PROBABILITIES; RADIATION PNEUMONITIS; MANTLE IRRADIATION; BREAST-CANCER; NORMAL TISSUE; PERFUSION SCANS; TOLERANCE;
Keywords:
RADIATION THERAPY; RADIATION INJURY; PNEUMONITIS; FIBROSIS; TRANSFORMING GROWTH FACTOR BETA; PULMONARY FUNCTION TESTS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
48
Recensione:
Indirizzi per estratti:
Citazione:
L.B. Marks et al., "PHYSICAL AND BIOLOGICAL PREDICTORS OF CHANGES IN WHOLE-LUNG FUNCTION FOLLOWING THORACIC IRRADIATION", International journal of radiation oncology, biology, physics, 39(3), 1997, pp. 563-570

Abstract

Purpose: To develop methods of predicting the pulmonary consequences of thoracic irradiation (RT) by prospectively studying changes in pulmonary function following RT. Methods and Materials: 100 patients receiving incidental partial-lung irradiation during treatment of tumors inor adjacent to the thorax had whole-lung function assessed via symptoms and pulmonary function tests (PFTs: FEV1-forced expiratory volume 1s; DLCO-diffusion capacity) before and repeatedly 6-48 months following RT. All had computed tomography-based three-dimensional (3D) dose calculations with lung density heterogeneity corrections for dose-volume histogram (DVH) and normal tissue complication probability (NTCP) calculations. Functional DVHs (DVfH) based on SPECT (single photon emission computed tomography) lung perfusion scans, and serial transforminggrowth factor-beta (TGF-beta(1)) levels were available in 50 and 48 patients, respectively. The incidence and severity of changes in whole-lung function were correlated with clinical, physical, and biological factors. Exploratory statistical analyses were performed using chi-square, Pearson correlations, logistic regression, and multiple linear regression. Results: RT-induced symptoms developed in 21 patients. In the overall group, the single best predictor for the development of symptoms was the NTCP (p < 0.05). Pre-RT PFTs alone were less predictive (p = 0.1 for FEV1, p = 0.08 for DLCO). A multivariate model based on pre-RT DLCO and CT-based NTCP was strongly predictive for the development of symptoms (p < 0.001). NTCPs based on SPECT-derived DVfHs and TGF-beta(1) levels did not appear to provide additional predictive value. The presence or absence of pulmonary symptoms was correlated with the decline in PFT 6 months following RT (p < 0.05). In the overall group,the degree of decline in PFTs was not well correlated with any of thedose-volume variables considered. In patients with ''good'' pre-RT PFTs, there was a relationship between the percent reduction in PFT and dose-volume parameters such as the percent of lung volume receiving > 30 Gy (p < 0.05). Conclusion: The extent of alteration in whole-lung function (symptoms or PFT changes) appears to be related to both dose-volume and pre-RT PFT parameters. The data suggest that no one variableis likely to be an adequate predictor and that multivariate predictive models will be needed. Additional studies are underway to develop better predictive models that consider physical factors such as the DVH and regional perfusion, as well as biologican/clinical factors such aspre-RT PFTs and TGF-beta(1). (C) 1997 Elsevier Science Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/04/20 alle ore 19:35:59