Chinese Clinical Oncology

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Correlations between dosevolume histogram parameters and radiationinduced lung injury for lung cancer patients treated with three-dimensional conformal radiotherapy and intensity-modulated radiotherapy

WANG Qiang,SHI Jian.   

  1. Department of Radiotherapy, Linzi District People's Hospital
  • Received:2013-12-13 Revised:2014-01-12 Online:2014-08-31 Published:2014-08-31

Abstract: Objective To investigate the effect of threedimensional conformal radiotherapy(3D-CRT) and intensitymodulated radiotherapy(IMRT) on radiationinduced lung injury(RILI) and their relations with parameters of dose volume histograms(DVH). Methods One hundred and fifty-one cases of locally advanced lung cancer patients treated with chemoradiotherapy from single clinical center were enrolled retrospectively, including 90 cases of 3D-CRT and 61 cases of IMRT. All patients were treated with radical radiotherapy dose, 1.8-2.0Gy per fraction, 5 fracions one week, and the median prescribed dose was 60.0Gy. RILI was defined according to the National Cancer Institute Common Toxicity Criteria, version 30. The incidence of RILI in two groups was calculated and its association with the parameters of DVH were analyzed. Results The incidence of RILI(≥grade 2) in 3D-CRT group was lower than that in IMRT group(17.8% vs. 24.6%); on the contrary, the incidence of RILI(≥grade 3) in 3DCRT group was higher than that in IMRT group(8.9% vs. 3.3%). However, there was no statistically significant difference(P>0.05). In 3D-CRT group, V20 would increase the risk of RILI(OR=3.780, P=0.030), whereas, in IMRT group, V5, V10, V13, V20 and mean lung dose would increase the risk of the RILI(OR=3.575-6.286, P=0.003-0.045) by univariate analysis. Multivariate analysis confirmed V20 was an independent risk factor. Conclusion 3D-CRT and IMRT seemed to have no significant effect on RILI(≥grade 2), and V20 is tightly correlated with RILI.

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