Radiation-induced dyspnea in lung cancer patients treated with stereotactic body radiation therapy Journal Article
| Authors: | Cella, L.; Monti, S.; Thor, M.; Rimner, A.; Deasy, J. O.; Palma, G. |
| Article Title: | Radiation-induced dyspnea in lung cancer patients treated with stereotactic body radiation therapy |
| Abstract: | In this study, we investigated the prognostic factors for radiation-induced dyspnea after hypo-fractionated radiation therapy (RT) in 106 patients treated with Stereotactic Body RT for Non-Small-Cell Lung Cancer (NSCLC). The median prescription dose was 50 Gy (range: 40-54 Gy), delivered in a median of four fractions (range: 3-12). Dyspnea within six months after SBRT was scored according to CTCAE v.4.0. Biologically Effective Dose (α/β = 3 Gy) volume histograms for lungs and heart were extracted. Dosimetric parameters along with patient-specific and treatment-related factors were analyzed, multivariable logistic regression method with Leave-One-Out (LOO) internal validation applied. Model performance was evaluated by the area under the receiver operating characteristic (ROC) curve (AUC) and calibration plot parameters. Fifty-seven patients (53.8%) out of 106 developed dyspnea of any grade after SBRT (25/57 grade ≥ 2 cases). A three-variable predictive model including patient comorbidity (COPD), heart volume and the relative lungs volume receiving more than 15 Gy was selected. The model displays an encouraging performance given by a training ROC-AUC = 0.71 [95%CI 0.61-0.80] and a LOO-ROC-AUC = 0.64 [95%CI 0.53-0.74]. Further modeling efforts are needed for dyspnea prediction in hypo-fractionated treatments in order to identify patients at high risk for developing lung toxicity more accurately. © 2021 by the authors. |
| Keywords: | adult; aged; major clinical study; cancer patient; calibration; risk factors; lung cancer; retrospective study; risk factor; dyspnea; dosimetry; comorbidity; stereotactic body radiation therapy; chronic obstructive lung disease; histogram; receiver operating characteristic; ntcp; diagnostic test accuracy study; heart volume; lung volume; human; male; female; article; effective dose (radiation); leave one out cross validation |
| Journal Title: | Cancers |
| Volume: | 13 |
| Issue: | 15 |
| ISSN: | 2072-6694 |
| Publisher: | MDPI |
| Date Published: | 2021-08-01 |
| Start Page: | 3734 |
| Language: | English |
| DOI: | 10.3390/cancers13153734 |
| PROVIDER: | scopus |
| PMCID: | PMC8345168 |
| PUBMED: | 34359634 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 September 2021 -- Source: Scopus |
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