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Japanese Journal of Clinical Oncology
Year: 2010  |  Volume: 40  |  Issue: 5  |  Page No.: 464 - 469

Radiation Pneumonitis Following Twice-daily Radiotherapy with Concurrent Carboplatin and Paclitaxel in Patients with Stage III Non-small-cell Lung Cancer

H Kobayashi, T Uno, K Isobe, N Ueno, M Watanabe, R Harada, Y Takiguchi, K Tatsumi and H. Ito    

Abstract: Objective

To examine the effects of dose–volume factors on the development of radiation pneumonitis in patients with non-small-cell lung cancer who received twice-daily radiotherapy concurrently with carboplatin and paclitaxel chemotherapy.

Methods

Radiotherapy consisted of twice-daily fractionation of 1.2 Gy, to a total dose of 60 Gy. Weekly carboplatin and paclitaxel were used as a concurrent chemotherapy. Effects of radiotherapy parameters on the development of radiation pneumonitis were retrospectively analyzed.

Results

Fourteen of 37 patients developed Grade 2 or worse (≥G2) radiation pneumonitis. Grade 2 or worse radiation pneumonitis occurred in all 5 patients with V5 >40%, all 4 patients with V10 >35%, all 4 patients with V13 >32%, 9 of 14 patients with V20 >24% and 8 of 11 patients with V30 >22%, whereas 9 of 32 patients with V5 <40%, 10 of 33 patients with V10 <35%, 10 of 33 patients with V13 <32%, 5 of 23 patients with V20 <24% and 6 of 26 patients with V30 <22%, with respective P values of 0.0045, 0.015, 0.015, 0.015 and 0.008. Eight of 11 patients with a mean lung dose of >14 Gy developed ≥G2 radiation pneumonitis in contrast to 6 of 26 patients with a mean lung dose of <14 Gy (P = 0.008).

Conclusions

Several cut-off values in the Vdose and the mean lung dose differentiating probabilities of developing ≥G2 radiation pneumonitis were identified in this combination therapy.

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