Author of

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  P2.12 - Small Cell Lung Cancer/NET (Not CME Accredited Session) (ID 961)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall

  • 27171

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    P2.12-18 - Interstitial Lung Abnormalities are a Risk Factor for Radiation Pneumonitis in Patients with Limited-Stage Small-Cell Lung Cancer  (ID 11923)

    16:45 - 18:00  |  Presenting Author(s): Fangjuan Li
    • Abstract

    Background
    

    Previous studies reported that patients wth preexisting radiological interstitial lung abnormalities (ILAs) were more susceptible to developing radiation pneumonitis (RP) after thoracic radiation therapy (TRT). The present study aimed to evaluate the incidence and predictors of RP after TRT in patients with limited-stage small-cell lung cancer (LS-SCLC) with or without preexisting radiological ILAs.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    A total of 183 consecutive patients with LS-SCLC between January 2015 and December 2016, who were treated with thoracic intensity-modulated radiation therapy at our institution, were analyzed. The diagnosis of ILAs was reviewed by two experienced thoracic radiologists based on the pretreatment high-resolution computed tomography(CT) imaging, such as honeycombing, subpleural reticular opacities, ground-glass opacity, and traction bronchiectasis. Univariate and multivariate analyses were used to assess the correlation of clinical factors, preexisting radiological ILAs, and dose-volume histogram-based dosimetric parameters with RP. The correlation between the preexisting ILAs score on CT findings and the grade of RP was analyzed by Pearson Correlation.

    4c3880bb027f159e801041b1021e88e8 Result
    

    Twenty (10.9%) patients had preexisting radiological ILAs. The median follow-up time was 10.9 months. RP was observed in 75 (41.0%), 35 (19.1%), 11 (6.0%), and 0 (0%) patients with grades 1, 2, 3, and ≥4 RP, respectively. The incidence of ≥ grade 2 and 3 RP at 1 year was 26.3% and 6.2% in the entire cohort, respectively. Preexisting radiological ILAs were associated with an increased risk of ≥grade 2 RP (84.1% in ILAs + vs 18.7% in ILAs-, P＜0.001) and ≥ grade 3 RP (27.7% in ILAs + vs 3.8% in ILAs-, P ＜0.001) at 1 year. Preexisting radiological ILAs was a significant predictors of ≥grade 2 RP and ≥grade 3 RP in multivariate analysis (P ＜0.001, P = 0.004, respectively). Lower forced expiratory volume in 1 second was a significant predictor of ≥grade 2 RP in multivariate analysis (P = 0.043). The ratio of CD4 and CD8 cells has a tendency to predict ≥grade 3 RP in multivariate analysis (P = 0.053).There was a moderate correlation between the preexisting ILAs score on CT findings and the grade of RP (Pearson Correlation Coefficient = 0.364, P ＜0.001).

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    Preexisting radiological ILAs is associated with an increased risk of ≥grade 2 RP and ≥grade 3 RP after TRT in patients with LS-SCLC.

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