Severity of radiation pneumonitis, from clinical, dosimetric and biological features: a pilot study

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dc.citation.articleNumber246en_US
dc.citation.journalTitleRadiation Oncologyen_US
dc.citation.volumeNumber15en_US
dc.contributor.authorAso, Samanthaen_US
dc.contributor.authorNavarro‑Martin, Arturoen_US
dc.contributor.authorCastillo, Richarden_US
dc.contributor.authorPadrones, Susanaen_US
dc.contributor.authorCastillo, Edwarden_US
dc.contributor.authorMontes, Anaen_US
dc.contributor.authorMartínez, José Ignacioen_US
dc.contributor.authorCubero, Noeliaen_US
dc.contributor.authorLópez, Rosaen_US
dc.contributor.authorRodríguez, Lauraen_US
dc.contributor.authorPalmero, Ramonen_US
dc.contributor.authorManresa, Federicoen_US
dc.contributor.authorGuerrero, Thomasen_US
dc.contributor.authorMolina, Maríaen_US
dc.date.accessioned2021-12-17T20:09:12Zen_US
dc.date.available2021-12-17T20:09:12Zen_US
dc.date.issued2020en_US
dc.description.abstractBackground and objective: Radiation pneumonitis (RP) could be a lethal complication of lung cancer treatment. No reliable predictors of RP severity have been recognized. This prospective pilot study was performed to identify early predictors of high grade lung toxicity and to evaluate clinical, biological or dosimetric features associated with different grades of toxicity. Method: Sixteen patients with non-small cell lung cancer with indication of concurrent chemoradiotherapy using 60 Gy/2 Gy/fraction starting at cycle one of platinum based chemotherapy were included. Bronchoalveolar lavage (BAL), pulmonary function testing (PFT), and 18F-2-fluoro-2-deoxy-D-glucose positron-emission tomography was performed before radiotherapy (RT), after three weeks of treatment, and two months post-RT. For analysis, patients were grouped by grade (low [G1-G2] vs. high [G3-G5]). The two groups were compared to identify predictors of RP. Protein expression BAL and lung tissue metabolism was evaluated in two patients (RP-G1 vs. RP-G3). Categorical variables such as comorbidities, stages and locations were summarized as percentages. Radiation doses, pulmonary function values and time to RP were summarized by medians with ranges or as means with standard deviation. Longitudinal analysis PFT was performed by a T-test. Results: All 16 patients developed RP, as follows: G1 (5 pts; 31.3%); G2 (5 pts; 31.3%); G3 (5 pts; 31.3%); and G5 (1 pts; 6.1%). Patients with high grade RP presented significant decrease (p = 0.02) in diffusing lung capacity for carbon monoxide (DLCO) after three weeks of RT. No correlation between dosimetric values and RP grades was observed. BAL analysis of the selected patients showed that CXCL-1, CD154, IL-1ra, IL-23, MIF, PAI-1 and IFN-γ were overexpressed in the lungs of the RP-G3 patient, even before treatment. The pre-RT SUVmax value in the RP-G3 patient was non-significantly higher than in the patient with RP-G1. Conclusions: RT induces some degree of RP. Our data suggest that decrease in DLCO% is the most sensitive parameter for the early detection of RP. Moreover, we detect biological differences between the two grades of pneumonitis, highlighting the potential value of some cytokines as a prognostic marker for developing high grade lung toxicity. Further multicenter studies with larger sample size are essential to validate these findings.en_US
dc.identifier.citationAso, Samantha, Navarro‑Martin, Arturo, Castillo, Richard, et al.. "Severity of radiation pneumonitis, from clinical, dosimetric and biological features: a pilot study." <i>Radiation Oncology,</i> 15, (2020) Springer Nature: https://doi.org/10.1186/s13014-020-01694-1.en_US
dc.identifier.digitals13014-020-01694-1en_US
dc.identifier.doihttps://doi.org/10.1186/s13014-020-01694-1en_US
dc.identifier.urihttps://hdl.handle.net/1911/111887en_US
dc.language.isoengen_US
dc.publisherSpringer Natureen_US
dc.rightsThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.en_US
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/.en_US
dc.titleSeverity of radiation pneumonitis, from clinical, dosimetric and biological features: a pilot studyen_US
dc.typeJournal articleen_US
dc.type.dcmiTexten_US
dc.type.publicationpublisher versionen_US
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