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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MSK Authors
  1. Andreas Rimner
    392 Rimner
  2. Joseph Owen Deasy
    410 Deasy
  3. Maria Elisabeth Thor
    104 Thor