Analysis of clinical and dosimetric factors associated with radiation pneumonitis in patients with lung cancer or esophageal cancer treated with intensity-modulated radiotherapy

OBJECTIVE: To evaluate the association between the epidemiological,clinical,and dosimetric factors and radiation pneumonitis in patients with lung cancer or esophageal cancer treated with intensity-modulated radiotherapy.METHODS: Totally 143 patients with lung cancer or esophageal cancer treated with intensity-modulated radiotherapy between January 2007 and December 2010 were analyzed.Radiation pneumonitis was defined and graded according to common terminology criteria for adverse events(CTCAE) version 3.0.The epidemiological,clinical,and dosimetric factors were analyzed using χ2 tests and t test.Univariate and multivariate Logistic regression analyses were used to evaluate the association between related factors and radiation pneumonitis.RESULTS: Among 143 patients,26(18.18%) developed radiation pneumonitis.The 1-4 grade radiation pneumonitis were 13(9.09%),8(5.59%),3(2.10%) and 2(1.40%).Logistic regression analyses showed that previous chemotherapy,previous radiation,concurrent chemotherapy,ECOG score,radiation target,single dose,mean lung dose,V20,V30 and V40 were associated with radiation pneumonitis.CONCLUSION: Some clinical and dosimetric factors are the useful indicators to predict radiation pneumonitis in patients with lung cancer or esophageal cancer treated with intensity-modulated radiotherapy.