Influence of Different Radio-chemotherapy Modes for Incidence of Radiation Pneumonitis in Patients with Lung Cancer

Abstract

Objective To compare the difference of different radio-chemotherapy modes and clinical characters for more than grade 2 radiation pneumonitis (RP) incidence in patients with lung cancer. Methods We retrospectively analyzed the 136 patients with lung cancer who were treated with radio-chemotherapy in our hospital from January 2014 to January 2016. Following-up was undergone regularly after treatment. RTOG standard of acute radiation pneumonia was applied to evaluate lung injury grade. We also analyzed the effect of clinical character and treatment modes on RP. Results There were 36 cases diagnosed as ≥grade 2 RP, and the occurrence rate was 26.5%. The patients with dust exposure history(P=0.048) and NSCLC pathology type (P=0.047) had a higher RP incidence, while other characters had no statistical difference. Comparing between concomitant chemoradiation group and sequential chemoradiation group, there was statistical difference in the incidence of ≥grade 4 RP (6.7% vs. 0, P=0.05), however, no statistical difference in overall RP, grade 2 or grade 3 RP. There was no statistical difference among different chemotherapy regimens to ≥grade 2 RP. There was significantly positive correlation of RP severity with the total chemotherapy cycles or induction chemotherapy cycles(P=0.000). Conclusion Dust exposure history and pathology type are two clinical character factors to influence the incidence of RP. RP is closely related to the chemotherapy cycles, especially in total chemotherapy cycles or induction chemotherapy cycles.

Keywords

• radiotherapy
• chemotherapy
• pulmonary malignant tumor
• radiation pneumonitis