Patient-reported lung symptoms as an early signal of impending radiation pneumonitis in patients with non-small cell lung cancer treated with ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2018-03-16

AUTHORS

Jinbo Yue, Qiuling Shi, Ting Xu, Melenda Jeter, Ting-Yu Chen, Ritsuko Komaki, Daniel R. Gomez, Tinsu Pan, Charles S. Cleeland, Zhongxing Liao, Xin Shelley Wang

ABSTRACT

PurposeClinician ratings of concurrent chemoradiation (CRT)-induced radiation pneumonitis (RP) in patients with non-small cell lung cancer (NSCLC) are based on both imaging and patient-reported lung symptoms. We compared the value of patient-reported outcomes versus normal-lung uptake of 18F-fluoro-2-deoxyglucose in positron emission computed tomography (FDG PET/CT) during the last week of treatment, for indicating the development of grade ≥ 2 RP within 4 months of CRT completion.Methods132 patients with NSCLC-reported RP-related symptoms (coughing, shortness of breath) repeatedly using the validated MD Anderson Symptom Inventory lung cancer module. Of these patients, 68 had FDG PET/CT scans that were analyzed for normal-lung mean standardized FDG uptake values (SUVmean) before, during, and up to 4 months after CRT. Clinicians rated RP using CTCAE version 3. Logistic regression models examined potential predictors for developing CTCAE RP ≥ 2.ResultsFor the entire sample, patient-rated RP-related symptoms during the last week of CRT correlated with clinically meaningful CTCAE RP ≥ 2 post-CRT (OR 2.74, 95% CI 1.25–5.99, P = 0.012), controlled for sex, age, mean lung radiation dose, comorbidity, and baseline symptoms. Moderate/severe patient-rated RP-related symptom score (≥ 4 on a 0–10 scale, P = 0.001) and normal-lung FDG uptake (SUVmean > 0.78, P = 0.002) in last week of CRT were equally strong predictors of post-CRT CTCAE RP ≥ 2 (C-index = 0.78, 0.77).ConclusionsDuring the last week of CRT, routine assessment of moderate-to-severe RP-related symptoms provides a simple way to identify patients with NSCLC who may be at risk for developing significant post-CRT RP, especially when PET/CT images of normal-lung FDG uptake are not available. More... »

PAGES

1563-1570

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11136-018-1834-3

DOI

http://dx.doi.org/10.1007/s11136-018-1834-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1101552847

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/29549533


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