PMID- 29066051
OWN - NLM
STAT- MEDLINE
DCOM- 20190408
LR  - 20190408
IS  - 1938-0690 (Electronic)
IS  - 1525-7304 (Linking)
VI  - 19
IP  - 2
DP  - 2018 Mar
TI  - Impact of Pretreatment Interstitial Lung Disease on Radiation Pneumonitis and 
      Survival in Patients Treated With Lung Stereotactic Body Radiation Therapy 
      (SBRT).
PG  - e219-e226
LID - S1525-7304(17)30208-5 [pii]
LID - 10.1016/j.cllc.2017.06.021 [doi]
AB  - INTRODUCTION: The purpose of this study was to determine the impact of 
      interstitial lung disease (ILD) on radiation pneumonitis (RP) and overall 
      survival (OS) in lung stereotactic body radiation therapy (SBRT). METHODS: 
      Patients treated with lung SBRT from 2004 to 2015 were included. Pretreatment 
      computed tomography scans were reviewed and classified for interstitial changes 
      by thoracic radiologists using American Thoracic Society guidelines and Washko 
      and Kazerooni scores. RP was scored prospectively using Common Terminology 
      Criteria for Adverse Events, version 3.0. Pretreatment imaging characteristics, 
      clinical variables, and dosimetry were assessed by univariate (UVA) and 
      multivariate analysis (MVA). OS was assessed by the log-rank test, and the impact 
      of ILD on OS was assessed by Cox regression. RESULTS: Of the 537 patients 
      assessed, 39 had interstitial changes (13 usual interstitial pneumonia [UIP], 24 
      possible UIP, and 2 inconsistent with UIP). RP was significantly higher in 
      patients with ILD than in patients without ILD (grade >/= 2, 20.5% vs. 5.8%; P < 
      .01; grade >/= 3, 10.3% vs. 1.0%; P < .01). Two of 3 grade 5 RP had imaging 
      features of ILD. On UVA, ILD, Washko score, lung parameters performance status, 
      and dose were significant predictors of grade >/= 2 RP. On MVA, ILD (odds ratio, 
      5.81; 95% confidence interval, 2.28-14.83; P < .01) and mean lung dose (odds 
      ratio, 1.40; 95% confidence interval, 1.14-1.71; P < .01) were predictors of RP. 
      ILD did not significantly affect OS on UVA or MVA. Median survival was 27.4 
      months in the ILD cohort and 34.8 in the ILD-negative cohort (P = .17). 
      DISCUSSION: ILD is a significant risk factor for RP in patients treated with lung 
      SBRT. Computed tomography scans should be reviewed for evidence of ILD prior to 
      SBRT.
CI  - Copyright (c) 2017 Elsevier Inc. All rights reserved.
FAU - Glick, Daniel
AU  - Glick D
AD  - Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; 
      Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada.
FAU - Lyen, Stephen
AU  - Lyen S
AD  - Joint Department of Medical Imaging, Toronto General Hospital, Toronto, ON, 
      Canada.
FAU - Kandel, Sonja
AU  - Kandel S
AD  - Joint Department of Medical Imaging, Toronto General Hospital, Toronto, ON, 
      Canada.
FAU - Shapera, Shane
AU  - Shapera S
AD  - Division of Respirology, Toronto General Hospital, Toronto, ON, Canada.
FAU - Le, Lisa W
AU  - Le LW
AD  - Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, ON, 
      Canada.
FAU - Lindsay, Patricia
AU  - Lindsay P
AD  - Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; 
      Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada.
FAU - Wong, Olive
AU  - Wong O
AD  - Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada.
FAU - Bezjak, Andrea
AU  - Bezjak A
AD  - Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; 
      Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada.
FAU - Brade, Anthony
AU  - Brade A
AD  - Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; 
      Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada.
FAU - Cho, B C John
AU  - Cho BCJ
AD  - Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; 
      Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada.
FAU - Hope, Andrew
AU  - Hope A
AD  - Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; 
      Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada.
FAU - Sun, Alexander
AU  - Sun A
AD  - Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; 
      Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada.
FAU - Giuliani, Meredith
AU  - Giuliani M
AD  - Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; 
      Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada. 
      Electronic address: Meredith.Giuliani@rmp.uhn.ca.
LA  - eng
PT  - Journal Article
DEP - 20170710
PL  - United States
TA  - Clin Lung Cancer
JT  - Clinical lung cancer
JID - 100893225
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Lung/*physiology/radiation effects
MH  - *Lung Diseases, Interstitial
MH  - Lung Neoplasms/complications/*epidemiology/radiotherapy
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Radiation Pneumonitis/*epidemiology/etiology/mortality
MH  - Radiosurgery/*adverse effects
MH  - Risk Factors
MH  - Survival Analysis
MH  - Tomography, X-Ray Computed
OTO - NOTNLM
OT  - Early stage lung cancer
OT  - Interstitial pneumonia
OT  - Lung toxicity
OT  - Pulmonary fibrosis
OT  - SBRT
EDAT- 2017/10/27 06:00
MHDA- 2019/04/09 06:00
CRDT- 2017/10/26 06:00
PHST- 2017/04/06 00:00 [received]
PHST- 2017/06/29 00:00 [revised]
PHST- 2017/06/30 00:00 [accepted]
PHST- 2017/10/27 06:00 [pubmed]
PHST- 2019/04/09 06:00 [medline]
PHST- 2017/10/26 06:00 [entrez]
AID - S1525-7304(17)30208-5 [pii]
AID - 10.1016/j.cllc.2017.06.021 [doi]
PST - ppublish
SO  - Clin Lung Cancer. 2018 Mar;19(2):e219-e226. doi: 10.1016/j.cllc.2017.06.021. Epub 
      2017 Jul 10.