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Cancers 2018, 10(8), 257;

Stereotactic Body Radiation Therapy for Patients with Pulmonary Interstitial Change: High Incidence of Fatal Radiation Pneumonitis in a Retrospective Multi-Institutional Study

Department of Radiology, School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi 4093898, Japan
Department of Radiology, University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 1138655, Japan
Ion Beam Therapy Center, SAGA-HIMAT Foundation, 3049 Harukoga-machi, Tosu-shi, Saga 8410071, Japan
Department of Radiation Oncology, Niigata Cancer Center Hospital, 2-15-3 Kawagishi, Chuo-ku, Niigata 9518566, Japan
Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 6068507, Japan
Department of Radiology, School of Medicine, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 4678601, Japan
Department of Radiation Oncology, School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 9808574, Japan
Department of Radiology and Radiation Oncology, Hirosaki University School of Medicine, 5 Zaifu-cho Hirosaki city, Aomori 0368562, Japan
Department of Radiation Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 1138677, Japan
Department of Radiation Oncology, Hiroshima University Hospital, 1-2-3, Kasumi Minami-ku, Hiroshima 7348551, Japan
Department of Radiation Oncology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 2520375, Japan
Department of Radiation Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 1040045, Japan
Department of Radiation Oncology, Sapporo Medical University, 16-291 Minami-1jyo-nishi, Chuo-ku, Sapporo-shi, Hokkaido 0608543, Japan
Radiation Oncology Center, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura, Kanagawa 2470056, Japan
Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 2608670, Japan
Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata-shi, Yamagata 9909585, Japan
Department of Radiation Oncology, Kanazawa University, 13-1 Takaramachi, Kanazawa 9208641, Japan
Department of Radiation Oncology, Osaka University Graduate School of Medicine, 2-2 (D10) Yamada-oka, Suita, Osaka 5650871, Japan
Author to whom correspondence should be addressed.
Received: 31 May 2018 / Revised: 15 July 2018 / Accepted: 26 July 2018 / Published: 2 August 2018
(This article belongs to the Special Issue Recent Advances in Non-Small Cell Lung Cancer)
Full-Text   |   PDF [2222 KB, uploaded 2 August 2018]   |  


Pretreatment pulmonary interstitial change (PIC) has been indicated as a risk factor of severe radiation pneumonitis (RP) following stereotactic body radiation therapy (SBRT) for early-stage lung cancer, but details of its true effect remain unclear. This study aims to evaluate treatment outcomes of SBRT for stage I non-small cell lung cancer in patients with PIC. A total of 242 patients are included in this study (88% male). The median age is 77 years (range, 55–92 years). A total dose of 40–70 Gy is administered in 4 to 10 fractions during a 4-to-25 day period. One, two, and three-year overall survival (OS) rates are 82.1%, 57.1%, and 42.6%, respectively. Fatal RP is identified in 6.9% of all patients. The percent vital capacity <70%, mean percentage normal lung volume receiving more than 20 Gy (>10%), performance status of 2–4, presence of squamous cell carcinoma, clinical T2 stage, regular use of steroid before SBRT, and percentage predicting forced expiratory volume in one second (<70%) are associated with worse prognoses for OS. Our results indicate that fatal RP frequently occurs after SBRT for stage I lung cancer in patients with PIC. View Full-Text
Keywords: stereotactic body radiation therapy; lung cancer; pulmonary interstitial change; radiation pneumonitis stereotactic body radiation therapy; lung cancer; pulmonary interstitial change; radiation pneumonitis

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Onishi, H.; Yamashita, H.; Shioyama, Y.; Matsumoto, Y.; Takayama, K.; Matsuo, Y.; Miyakawa, A.; Matsushita, H.; Aoki, M.; Nihei, K.; Kimura, T.; Ishiyama, H.; Murakami, N.; Nakata, K.; Takeda, A.; Uno, T.; Nomiya, T.; Takanaka, T.; Seo, Y.; Komiyama, T.; Marino, K.; Aoki, S.; Saito, R.; Araya, M.; Maehata, Y.; Tominaga, L.; Kuriyama, K. Stereotactic Body Radiation Therapy for Patients with Pulmonary Interstitial Change: High Incidence of Fatal Radiation Pneumonitis in a Retrospective Multi-Institutional Study. Cancers 2018, 10, 257.

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