New dose constraint reduces radiation-induced fatal pneumonitis in locally advanced non-small cell lung cancer patients treated with intensity-modulated radiotherapy

• DOI: 10.3109/0284186x.2015.1061216
• Publication Date: 2015-10-20T16:44:02Z
• Authors: Azza A. Khalil; Lone Hoffmann; Ditte S. Moeller; Katherina P. Farr; Marianne M. Knap
• Keywords: Pneumonitis

Intensity-modulated radiotherapy (IMRT) in locally advanced non-small cell lung cancer (NSCLC) allows treatment of patients with large tumour volumes, but radiation pneumonitis (RP) remains a dose limiting complication. The incidence severe RP using three-dimensional (3D) conformal radiotherapy, was previously reported to be 17%, 2% lethal RP. aim this study monitor the following introduction IMRT.IMRT delivered 4-8 beam arrangements and introduced three phases. In phase I, 12 were treated only one constraint (V20), which total volume receiving 20 Gy limited 40%. II, 25 an additional mean (MLD) ≤ Gy. III, 50 extra (V5) 5 60%. prospectively documented. results I & II (IMRT-1) compared those III (IMRT-2).The median follow-up time 17 months. IMRT associated increase Phase I&II 41%, six 37 (16%) had grade (IMRT-1). Introducing V5, led significant reduction doses from 51 ± 41 1% (p < 0.0001). V5 did not decrease (grade ≥ 3) RP, significantly decreased 4% (two patients), p = 0.05.Introducing resulted fatal however new low reduced pneumonitis.