Application of a radiation pneumonitis prediction model in patients with locally advanced lung squamous cell cancer.
BACKGROUND
The aim of the present study was to establish a new prediction model for radiation pneumonitis (RP) in locally advanced non-small cell lung cancer (LA-NSCLC) patients before and after radiotherapy.


METHODS
The study involved 153 patients. Age, arterial partial oxygen pressure (PO2), forced vital capacity, pulmonary emphysema (PE), subclinical interstitial lung disease (sILD), and dosimetric parameters, such as mean lung dose and percentage of lung volume, and a dose >5/20 Gy (V5/V20), were considered candidate RP predictors.


RESULTS
Of the 153 eligible patients, 33 (21.6%) developed RP, 68 had PE (43.8%), and 24 (15.7%) had sILD. Grades 2, 3, and 5 RP were scored in 17 (11.1%), 15 (9.8%), and 1 (0.7%) patient/s, Grade 4 RP was not observed. Grades 1, 2, and 3 PE were scored in 45 (29.4%), 22 (14.4%), and 1 (0.7%) patient/s. Grades 0 and 1 sILD were observed in 129 (84.3%) and 24 (15.7%) patients. Univariate analysis found age, PE, and sILD to be significantly correlated with grade ≥2 RP. Multivariate analysis revealed age >68 years, PE grade >1, and sILD grade ≥1 as independent risk factor for grade ≥2 RP in LA-NSCLC with squamous cell carcinoma (SCC). Finally, a new predictive risk score (PRS) comprised of these factors was developed. The PRS score was 0, 3-5, and 6-11 when the cumulative incidence of grade ≥2 RP was 8.8% (5 patients), 13% (3 patients), and 84.6% (13 patients) (P=<0.001).


CONCLUSIONS
Age, PE, and sILD could independently and significantly predict RP in LA-NSCLC with SCC.
['Wu|Ailu|A|', 'Zhou|Ziyang|Z|', 'Song|Yipeng|Y|', 'Liang|Shixiong|S|', 'Li|Fangjuan|F|']
D000368:Aged D002289:Carcinoma, Non-Small-Cell Lung D002294:Carcinoma, Squamous Cell D006801:Humans D008168:Lung D008175:Lung Neoplasms D017564:Radiation Pneumonitis D011879:Radiotherapy Dosage D012189:Retrospective Studies
radiation pneumonitis Locally advanced non-small cell lung cancer age pulmonary emphysema subclinical interstitial lung disease