PMID- 31855325
OWN - NLM
STAT- MEDLINE
DCOM- 20210305
LR  - 20210305
IS  - 1759-7714 (Electronic)
IS  - 1759-7706 (Print)
IS  - 1759-7706 (Linking)
VI  - 11
IP  - 2
DP  - 2020 Feb
TI  - Pulmonary function decreases moderately after accelerated high-dose irradiation 
      for stage III non-small cell lung cancer.
PG  - 369-378
LID - 10.1111/1759-7714.13276 [doi]
AB  - BACKGROUND: Chemoradiotherapy (CRT) is the standard treatment for patients with 
      inoperable stage III non-small cell lung cancer (NSCLC) stage III. With a median 
      OS beyond 30 months, adequate pulmonary function (PF) is essential to ensure 
      acceptable quality of life after treatment. Forced expiratory volume in 1 second 
      (FEV1) and diffusing capacity of the lung for carbon monoxide (DLCO) are the most 
      widely used parameters to assess lung function. The aim of the current study was 
      to evaluate dose-volume effects of accelerated high-dose radiation on PF. 
      METHODS: A total of 72 patients were eligible for the current analysis. After 
      induction chemotherapy, all patients received dose-differentiated accelerated 
      radiotherapy with intensity-modulated radiotherapy (IMRT-DART). PF tests were 
      performed six weeks, three and six months after the end of radiotherapy. RESULTS: 
      The median total dose to the tumor was 73.8 Gy (1.8 Gy bid) with a size dependent 
      range between 61.2 and 90 Gy. In the whole cohort, 321 pulmonary function tests 
      were performed. At six months, the median FEV1 relative to baseline was 0.95 
      (range: 0.56-1.36), and the relative median DLCO decreased to 0.98 (range: 
      0.64-1.50). The correlation between V20(total lung) and FEV1 decline was 
      statistically significant (P = 0.023). A total of 13 of 34 (38%) COPD patients 
      had a 4%-21% FEV1 decrease. CONCLUSION: Patients with a V20(total lung)  < 21% 
      are at a low risk for PF decrease after high dose irradiation treatment. Although 
      overall short term FEV1 and DLCO differ only moderately from baseline these 
      changes may be clinically important, especially in patients with COPD. KEY 
      POINTS: Significant findings: Pulmonary function after high dose irradiation 
      decreases only moderately. FEV1 and DLCO decrease depend on V20(total lung) . 
      Small differences in lung function may be clinically important for COPD patients. 
      KPS predicts minimal clinically important differences (MCID). WHAT THIS STUDY 
      ADDS: This study shows that high-dose irradiation delivered with 
      intensity-modulated techniques does not impair short-term lung function even in 
      patients with compromised respiratory capacity before treatment. This is a 
      pre-requisite for adequate quality of life after thoraco-oncological therapy.
CI  - (c) 2019 The Authors. Thoracic Cancer published by China Lung Oncology Group and 
      John Wiley & Sons Australia, Ltd.
FAU - Grambozov, Brane
AU  - Grambozov B
AD  - Department of Radiation Oncology, Paracelsus Medical University, SALK, Salzburg, 
      Austria.
FAU - Wolf, Frank
AU  - Wolf F
AD  - Department of Radiation Oncology, Paracelsus Medical University, SALK, Salzburg, 
      Austria.
FAU - Kaiser, Julia
AU  - Kaiser J
AD  - Department of Radiation Oncology, Paracelsus Medical University, SALK, Salzburg, 
      Austria.
FAU - Wass, Romana
AU  - Wass R
AD  - Department of Pneumology, Paracelsus Medical University, SALK, Salzburg, Austria.
FAU - Fastner, Gerd
AU  - Fastner G
AD  - Department of Radiation Oncology, Paracelsus Medical University, SALK, Salzburg, 
      Austria.
FAU - Gaisberger, Christoph
AU  - Gaisberger C
AD  - Department of Radiation Oncology, Paracelsus Medical University, SALK, Salzburg, 
      Austria.
FAU - Rettenbacher, Lukas
AU  - Rettenbacher L
AD  - Department of Radiation Oncology, Paracelsus Medical University, SALK, Salzburg, 
      Austria.
FAU - Studnicka, Michael
AU  - Studnicka M
AD  - Department of Pneumology, Paracelsus Medical University, SALK, Salzburg, Austria.
FAU - Pirich, Christian
AU  - Pirich C
AD  - Department of Nuclear Medicine, Paracelsus Medical University, SALK, Salzburg, 
      Austria.
FAU - Sedlmayer, Felix
AU  - Sedlmayer F
AD  - Department of Radiation Oncology, Paracelsus Medical University, SALK, Salzburg, 
      Austria.
AD  - radART - Institute for Research and Development on Advanced Radiation 
      Technologies, Paracelsus Medical University, Salzburg, Austria.
FAU - Zehentmayr, Franz
AU  - Zehentmayr F
AUID- ORCID: 0000-0001-5931-3907
AD  - Department of Radiation Oncology, Paracelsus Medical University, SALK, Salzburg, 
      Austria.
AD  - radART - Institute for Research and Development on Advanced Radiation 
      Technologies, Paracelsus Medical University, Salzburg, Austria.
LA  - eng
PT  - Journal Article
DEP - 20191219
PL  - Singapore
TA  - Thorac Cancer
JT  - Thoracic cancer
JID - 101531441
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Carcinoma, Non-Small-Cell Lung/*pathology/radiotherapy
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Lung/*physiopathology/radiation effects
MH  - Lung Neoplasms/*pathology/radiotherapy
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Radiotherapy Dosage
MH  - Radiotherapy, Intensity-Modulated/*mortality
MH  - Respiratory Function Tests
MH  - Survival Rate
PMC - PMC6996983
OTO - NOTNLM
OT  - DLCO
OT  - FEV1
OT  - NSCLC
OT  - minimal clinically important difference (MCID)
OT  - radiotherapy
EDAT- 2019/12/20 06:00
MHDA- 2021/03/06 06:00
PMCR- 2020/02/01
CRDT- 2019/12/20 06:00
PHST- 2019/10/02 00:00 [received]
PHST- 2019/11/21 00:00 [revised]
PHST- 2019/11/23 00:00 [accepted]
PHST- 2019/12/20 06:00 [pubmed]
PHST- 2021/03/06 06:00 [medline]
PHST- 2019/12/20 06:00 [entrez]
PHST- 2020/02/01 00:00 [pmc-release]
AID - TCA13276 [pii]
AID - 10.1111/1759-7714.13276 [doi]
PST - ppublish
SO  - Thorac Cancer. 2020 Feb;11(2):369-378. doi: 10.1111/1759-7714.13276. Epub 2019 
      Dec 19.