Prospective studies are needed to validate our findings. The DLCO% and MLD may predict the risk for SARP among patients with pre-treatment moderate pulmonary dysfunction who receive dCCRT for NSCLC. Compared to the MLD-low/DLCO%-high group, the MLD-high/DLCO%-low group had the highest risk for SARP, with an HR of 9.346 (95% CI: 2.133–40.941, p = 0.003). The ROC AUC of combined DLCO%/MLD was 0.775 (95% confidence interval : 0.688–0.861, p = 0.001), with a sensitivity and specificity of 0.871 and 0.637, respectively this was superior to DLCO% (0.656) or MLD (0.667) alone. Univariate and multivariate analysis indicated that the ratio of carbon monoxide diffusing capacity (DLCO% odds ratio : 0.934, 95% confidence interval 0.896–0.974, p = 0.001) and mean lung dose (MLD OR: 1.002, 95% CI 1.001–1.003, p = 0.002) were independent predictors of SARP. Logistic regression, receiver operating characteristics curves (ROC), and hazard ratio (HR) analyses were performed to evaluate the predictive value of each factor for SARP. SARP was defined as grade ≥3 RP occurring during or within 3 months after CCRT. The clinical outcomes, dose–volume histograms (DVH), and PF parameters of 122 patients (forced expiratory volume in 1 s : 60–69%) receiving dCCRT between 20 were recorded. We have previously reported on the incidence of SARP among patients with moderate pulmonary dysfunction who received definitive concurrent chemoradiotherapy (dCCRT) for non-small cell lung cancer (NSCLC). Pre-treatment pulmonary function (PF) may influence its incidence.
Severe acute radiation pneumonitis (SARP) is a life-threatening complication of thoracic radiotherapy.
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