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T. Doel



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    MA 09 - The Current Status of Radiation Oncology (ID 666)

    • Event: WCLC 2017
    • Type: Mini Oral
    • Track: Locally Advanced NSCLC
    • Presentations: 1
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      MA 09.10 - Toward a Radiological Scoring System of Radiotherapy-Induced Lung Damage (ID 8336)

      11:00 - 12:30  |  Author(s): T. Doel

      • Abstract
      • Presentation
      • Slides

      Background:
      There is no objective criteria to quantify radiotherapy-induced lung damage (RILD), leading to under-reporting of toxicity across centres and trials. Our objective is to build a radiological scoring system of RILD that correlates with decline in lung function.

      Method:
      Baseline and 12-month CT scans and formal respiratory function tests (FVC, FEV1 and DLCO) from 23 patients enrolled in an isotoxic chemoradiation clinical trial (IDEAL CRT) were available for central review. First, the presence of new CT findings of RILD was qualitatively scored into eleven sub-categories: consolidation, ground-glass opacities, traction bronchiectasis, reticulation, pleural thickening, pleural effusion, reduction in lung height, distortions of the diaphragm, fissures, anterior junction line and major airways. From these, three main categories were derived: parenchymal change, pleural changes and volume reduction. The correlation between number of features scored and decline in breathing function was investigated. Later, twelve imaging markers were defined to quantify the severity of the radiological findings. The correlation between each imaging marker and decline in breathing scores was also investigated.

      Result:
      Each patient scored either two or three (out of three) categories of damage. Differences in variation of FVC, FEV1 and DLCO between these two groups were statistically significant (p≤0.02). The number of sub-categories scored was moderately correlated with decline in FVC (ρ=-0.67, p<0.01), FEV1 (ρ=-0.41, p=0.05) and DLCO (ρ=-0.50, p=0.01). Six of the twelve imaging markers were moderately correlated with changes in FVC and FEV1 (ρ≈-0.5, p<0.05); five were weakly correlated (ρ≈-0.2, p<0.05). The strongest correlations were found for imaging markers that quantify change in lung volume and shape, mediastinal shift and pleural reaction. Figure 1 Figure- Relationship between radiological findings of RILD and changes in FVC.



      Conclusion:
      We investigated the relationship between radiological findings of RILD and decline in lung function. Our findings suggest that a scoring system can be proposed when investigated in a larger cohort.

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