Author of

• 31680

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  P2.16 - Treatment in the Real World - Support, Survivorship, Systems Research (ID 187)

  • Event: WCLC 2019
  • Type: Poster Viewing in the Exhibit Hall
  • Track: Treatment in the Real World - Support, Survivorship, Systems Research
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall

  • 31694

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    P2.16-13 - Risk Factors of Radiation Pneumonitis in Lung Cancer Patients with Subclinical Interstitial Lung Disease After Thoracic Radiotherapy (ID 1495)

    10:15 - 18:15  |  Author(s): Hongyu Wu
    • Abstract

    Background
    

    Previous studies reported that patients with subclinical interstitial lung disease were more susceptible to developing radiation pneumonitis after thoracic stereotactic body radiotherapy or thoracic radiation therapy. The present study aimed to evaluate the incidence and risk factors of radiation pneumonitis after thoracic radiation therapy in lung cancer patients with subclinical interstitial lung disease.

    Method
    

    Patients with subclinical interstitial lung disease between January 2016 and December 2017, who were treated with thoracic intensity-modulated radiation therapy in our institutions, were prospectively analyzed. The diagnosis of subclinical interstitial lung disease was based on the pretreatment high-resolution computed tomography imaging, such as honeycombing, subpleural reticular opacities, ground-glass opacity, and traction bronchiectasis. Statistical analysis was performed using SPSS software 22.0 for Mac. Univariate and multivariate analyses were used to assess the correlation of clinical factors, dose-volume histogram-based dosimetric parameters，and imaging characteristics of preexisting subclinical interstitial lung disease with radiation pneumonitis. A P value < 0.05 was considered statistically significant.

    Result
    

    A total of 87 consecutive patients with subclinical interstitial lung disease were prospectively analyzed. The median follow-up time was 14.1 months. RP was observed in 19 (21.8%), 27 (31.0%), 10 (11.5%), 3 (3.4%), and 5 (5.7%) patients with grades 1, 2, 3, 4 and 5 RP, respectively. The location of tumors and mean lung dose were significantly associated with ≥grade 2 RP in univariate analysis (P=0.043, P=0.024, respectively). Patients who received gemcitabine in the past and the involvement of subclinical interstitial lung disease ≥ 25% of the lung volume were significantly associated with ≥grade 3 radiation pneumonitis in univariate analysis (P=0.031, P=0.037, respectively). Patients who received gemcitabine in the past and the involvement of subclinical interstitial lung disease ≥ 25% of the lung volume were significantly associated with ≥grade 3 RP in multivariate analysis (P=0.046，P=0.017, respectively).

    Conclusion
    

    Subclinical interstitial lung disease is associated with an increased risk of radiation pneumonitis. Patients who received gemcitabine in the past and the involvement of subclinical interstitial lung disease ≥ 25% of the lung volume are associated with an increased risk of ≥grade 3 radiation pneumonitis.