International Journal of Radiation Oncology * Biology * Physics
Volume 77, Issue 3 , Pages 685-690 , 1 July 2010

Early Graphical Appearance of Radiation Pneumonitis Correlates With the Severity of Radiation Pneumonitis After Stereotactic Body Radiotherapy (SBRT) in Patients With Lung Tumors

  • Atsuya Takeda, M.D, Ph.D.

      Affiliations

    • Department of Radiology, Ofuna Chuo Hospital, Kanagawa, Japan
    • Department of Radiology, Tokyo Metropolitan Hiroo General Hospital, Tokyo, Japan
  • ,
  • Toshio Ohashi, M.D., Ph.D.

      Affiliations

    • Department of Radiology, Tokyo Metropolitan Hiroo General Hospital, Tokyo, Japan
    • Department of Radiology, Keio University, Tokyo, Japan
  • ,
  • Etsuo Kunieda, M.D., Ph.D.

      Affiliations

    • Department of Radiology, Keio University, Tokyo, Japan
    • Corresponding Author InformationReprint requests to: Etsuo Kunieda, M.D., Ph.D., Department of Radiology, Keio University, 35 Shinanomachi, Shinjuku, Tokyo 160-8582 Japan. Tel: (+81) 3-3353-1211 ex.62531; Fax: (+81) 3-3359-7425
  • ,
  • Tatsuji Enomoto, M.D., Ph.D.

      Affiliations

    • Department of Respirology, Tokyo Metropolitan Hiroo General Hospital, Tokyo, Japan
  • ,
  • Naoko Sanuki, M.D.

      Affiliations

    • Department of Radiology, Ofuna Chuo Hospital, Kanagawa, Japan
  • ,
  • Toshiaki Takeda, M.D.

      Affiliations

    • Department of Radiology, Tokyo Metropolitan Hiroo General Hospital, Tokyo, Japan
  • ,
  • Naoyuki Shigematsu, M.D., Ph.D.

      Affiliations

    • Department of Radiology, Keio University, Tokyo, Japan

Received 13 April 2009 ,Revised 30 May 2009 ,Accepted 1 June 2009.

References 

  1. Uematsu M, Shioda A, Suda A, et al. Computed tomography-guided frameless stereotactic radiotherapy for Stage I non–small cell lung cancer: A 5-year experience. Int J Radiat Oncol Biol Phys. 2001;51:666–670
  2. Onishi H, Shirato H, Nagata Y, et al. Hypofractionated stereotactic radiotherapy (HypoFXSRT) for Stage I non–small cell lung cancer: Updated results of 257 patients in a Japanese multi-institutional study. J Thorac Oncol. 2007;2:S94–100
  3. Nagata Y, Takayama K, Matsuo Y, et al. Clinical outcomes of a phase I/II study of 48 Gy of stereotactic body radiotherapy in 4 fractions for primary lung cancer using a stereotactic body frame. Int J Radiat Oncol Biol Phys. 2005;63:1427–1431
  4. Takeda A, Sanuki N, Kunieda E, et al. Stereotactic body radiotherapy for primary lung cancer at a dose of 50 Gy total in five fractions to the periphery of the planning target volume calculated using a superposition algorithm. Int J Radiat Oncol Biol Phys. 2009;73:442–448
  5. Hiraoka M, Ishikura SA. Japan clinical oncology group trial for stereotactic body radiation therapy of non–small cell lung cancer. J Thorac Oncol. 2007;2:S115–117
  6. Timmerman R, McGarry R, Yiannoutsos C, et al. Excessive toxicity when treating central tumors in a Phase II study of stereotactic body radiation therapy for medically inoperable early-stage lung cancer. J Clin Oncol. 2006;24:4833–4839
  7. Nagata Y, Matsuo Y, Takayama K, et al. National survey reports of stereotactic body radiotherapy [abstract]. Presented at the meeting of the Japan 3-D Conformal External Beam Radiotherapy Group 2006. Yamanashi, Japan, March 11, 2006.
  8. Onimaru R, Shirato H, Shimizu S, et al. Tolerance of organs at risk in small-volume, hypofractionated, image-guided radiotherapy for primary and metastatic lung cancers. Int J Radiat Oncol Biol Phys. 2003;56:126–135
  9. Yamashita H, Nakagawa K, Nakamura N, et al. Exceptionally high incidence of symptomatic Grade 2–5 radiation pneumonitis after stereotactic radiation therapy for lung tumors. Radiat Oncol. 2007;2:21
  10. Takeda A, Enomoto T, Sanuki N, et al. Acute exacerbation of subclinical idiopathic pulmonary fibrosis triggered by hypofractionated stereotactic body radiotherapy in a patient with primary lung cancer and slightly focal honeycombing. Radiat Med. 2008;26:504–507
  11. Mehta V. Radiation pneumonitis and pulmonary fibrosis in non-small-cell lung cancer: Pulmonary function, prediction, and prevention. Int J Radiat Oncol Biol Phys. 2005;63:5–24
  12. Takeda A, Kunieda E, Shigematsu N, et al. Small lung tumors: long-scan-time CT for planning of hypofractionated stereotactic radiation therapy—initial findings. Radiology. 2005;237:295–300
  13. Takeda A, Kunieda E, Sanuki N, et al. Dose distribution analysis in stereotactic body radiotherapy (SBRT) using dynamic conformal multiple arc therapy (DCMAT). Int J Radiat Oncol Biol Phys. 2009;74:363–369
  14. Kyas I, Hof H, Debus J, et al. Prediction of radiation-induced changes in the lung after stereotactic body radiation therapy of non-small-cell lung cancer. Int J Radiat Oncol Biol Phys. 2007;67:768–774
  15. Oh D, Ahn YC, Park HC, et al. Prediction of radiation pneumonitis following high-dose thoracic radiation therapy by 3 Gy/fraction for non-small cell lung cancer: Analysis of clinical and dosimetric factors. Jpn J Clin Oncol. 2009;39:151–157
  16. Fujino M, Shirato H, Onishi H, et al. Characteristics of patients who developed radiation pneumonitis requiring steroid therapy after stereotactic irradiation for lung tumors. Cancer J. 2006;12:41–46
  17. Sekine I, Sumi M, Ito Y, et al. Retrospective analysis of steroid therapy for radiation-induced lung injury in lung cancer patients. Radiother Oncol. 2006;80:93–97
  18. Wang S, Liao Z, Wei X, et al. Analysis of clinical and dosimetric factors associated with treatment-related pneumonitis (TRP) in patients with non-small-cell lung cancer (NSCLC) treated with concurrent chemotherapy and three-dimensional conformal radiotherapy (3D-CRT). Int J Radiat Oncol Biol Phys. 2006;66:1399–1407
  19. Roberts CM, Foulcher E, Zaunders JJ, et al. Radiation pneumonitis: A possible lymphocyte-mediated hypersensitivity reaction. Ann Intern Med. 1993;118:696–700
  20. Gibson PG, Bryant DH, Morgan GW, et al. Radiation-induced lung injury: A hypersensitivity pneumonitis?. Ann Intern Med. 1988;109:288–291
  21. Kataoka M, Kawamura M, Ueda N, et al. Diffuse gallium-67 uptake in radiation pneumonitis. Clin Nucl Med. 1990;15:707–711
  22. Aoki T, Nagata Y, Negoro Y, et al. Evaluation of lung injury after three-dimensional conformal stereotactic radiation therapy for solitary lung tumors: CT appearance. Radiology. 2004;230:101–108
  23. Takeda T, Takeda A, Kunieda E, et al. Radiation injury after hypofractionated stereotactic radiotherapy for peripheral small lung tumors: Serial changes on CT. AJR Am J Roentgenol. 2004;182:1123–1128
  24. Takenaka K, Yoshimura A, Okano T. Acute exacerbation of idiopathic interstitial pneumonia complicated by lung cancer, caused by treatment for lung cancer. Jpn J Lung Cancer. 1999;39:955–962
  25. Hanibuchi M, Yamguchi T, Okada T. Clinical examination of acute exacerbation of idiopathic interstitial pneumonia combined with lung cancer after-cancer treatment. Jpn J Lung Cancer. 2001;41:281–286

 Note—An online CME test for this article can be taken at http://asro.astro.org under Continuing Education.

 Conflict of interest: none.

PII: S0360-3016(09)00836-0

doi: 10.1016/j.ijrobp.2009.06.001

International Journal of Radiation Oncology * Biology * Physics
Volume 77, Issue 3 , Pages 685-690 , 1 July 2010