Journal
JOURNAL OF RADIATION RESEARCH
Volume 56, Issue 4, Pages 727-734Publisher
OXFORD UNIV PRESS
DOI: 10.1093/jrr/rrv019
Keywords
stereotactic body radiotherapy (SBRT); radiation-induced pneumonitis (RIP); prolonged minimal radiation-induced pneumonitis (pmRIP); Stage I lung cancer; chronic obstructive pulmonary disease (COPD)
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This retrospective study aimed to evaluate radiation-induced pneumonitis (RIP) and a related condition that we define in this report-prolonged minimal RIP (pmRIP)-after stereotactic body radiotherapy (SBRT) for Stage I primary lung cancer in patients with chronic obstructive pulmonary disease (COPD). We assessed 136 Stage I lung cancer patients with COPD who underwent SBRT. Airflow limitation on spirometry was classified into four Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades, with minor modifications: GOLD 1 (mild), GOLD 2 (moderate), GOLD 3 (severe) and GOLD 4 (very severe). On this basis, we defined two subgroups: COPD-free (COPD -) and COPD-positive (COPD +). There was no significant difference in overall survival or cause-specific-survival between these groups. Of the 136 patients, 44 (32%) had pmRIP. Multivariate analysis showed that COPD and the Brinkman index were statistically significant risk factors for the development of pmRIP. COPD and the Brinkman index were predictive factors for pmRIP, although our findings also indicate that SBRT can be tolerated in early lung cancer patients with COPD.
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