Clinical lung cancer · 2026
Clinical and Functional Factors Associated With Radiation Pneumonitis After Stereotactic Body Radiation Therapy for Lung Tumors: A Retrospective Cohort Study.
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Boutahir Anissa, Bouazzi Leila, Barbe Coralie, Deslee Gaetan, Dewolf Maxime, Ettalhaoui Leila, Invernizzi Camille, Lemoine Amelie, Meziane Yacine, Roque Alexandre, Ancel Julien, Beddok Arnaud
Аннотация
INTRODUCTION: To identify associated factors for radiation pneumonitis (RP) after stereotactic body radiation therapy (SBRT), focusing on pretreatment pulmonary function parameters and baseline clinical characteristics.
MATERIALS AND METHODS: Patients with primary or secondary lung tumors who underwent pulmonary function tests (PFTs) before SBRT were retrospectively analyzed. Clinical and imaging follow-up was conducted at 6 weeks, 6, 12, and 18 months post-treatment. RP diagnosis was based on clinical symptoms, bronchoscopic findings, radiological abnormalities, and their evolution over time. RP severity was graded according to common terminology criteria for adverse events v5.0 criteria. Associated factors were assessed using univariate and multivariate logistic regression analyses.
RESULTS: Between November 2016 and October 2023, 68 patients who received SBRT for lung tumors with available pretreatment PFTs were included. Median age was 70 years; 63.2% were male; 54.4% had chronic obstructive pulmonary disease, and 85.2% had primary lung cancer. RP occurred in 47 patients (69.1%), including 25% with grade 2 and 9.1% with grade 3 toxicity. In multivariate analysis, lower age (odd ratio [OR] 0.87 [0.77-0.98]; P = .02), higher total lung capacity (OR 1.13 [1.04-1.24]; P = .006), and higher diffusing capacity of the lung for carbon monoxide (OR 1.05 [1.01-1.10]; P = .01) were significantly associated with RP. Previous chemotherapy exposure was a protective factor for the occurrence of clinically significant RP (grade ≥ 2) (P = .02).
CONCLUSION: Age, diffusing capacity of the lung for carbon monoxide, and total lung capacity were identified as significant associated factors for RP after lung SBRT. Incorporating clinical, dosimetric, and functional respiratory parameters into a multifactorial predictive model could optimize patient selection and risk stratification.
MATERIALS AND METHODS: Patients with primary or secondary lung tumors who underwent pulmonary function tests (PFTs) before SBRT were retrospectively analyzed. Clinical and imaging follow-up was conducted at 6 weeks, 6, 12, and 18 months post-treatment. RP diagnosis was based on clinical symptoms, bronchoscopic findings, radiological abnormalities, and their evolution over time. RP severity was graded according to common terminology criteria for adverse events v5.0 criteria. Associated factors were assessed using univariate and multivariate logistic regression analyses.
RESULTS: Between November 2016 and October 2023, 68 patients who received SBRT for lung tumors with available pretreatment PFTs were included. Median age was 70 years; 63.2% were male; 54.4% had chronic obstructive pulmonary disease, and 85.2% had primary lung cancer. RP occurred in 47 patients (69.1%), including 25% with grade 2 and 9.1% with grade 3 toxicity. In multivariate analysis, lower age (odd ratio [OR] 0.87 [0.77-0.98]; P = .02), higher total lung capacity (OR 1.13 [1.04-1.24]; P = .006), and higher diffusing capacity of the lung for carbon monoxide (OR 1.05 [1.01-1.10]; P = .01) were significantly associated with RP. Previous chemotherapy exposure was a protective factor for the occurrence of clinically significant RP (grade ≥ 2) (P = .02).
CONCLUSION: Age, diffusing capacity of the lung for carbon monoxide, and total lung capacity were identified as significant associated factors for RP after lung SBRT. Incorporating clinical, dosimetric, and functional respiratory parameters into a multifactorial predictive model could optimize patient selection and risk stratification.