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Radiation Pneumonitis

Vanessa Figlia, Rosario Mazzola, Francesco Cuccia, Filippo Alongi, Gianluca Mortellaro, Daniela Cespuglio, Teresa Cucchiara, Giuseppina Iacoviello, Vito Valenti, Massimo Molino, Francesco Verderame, Domenica Matranga, Antonio Lo Casto, Giuseppe Ferrera
BACKGROUND: Several experiences in the literature report SBRT as an effective treatment option for medically inoperable early stage non-small cell lung cancer (NSCLC) and oligometastatic disease. The optimal fractionation schedules and total dose remain controversial. In this study, we evaluated the safety in terms of toxicity and efficacy of using of 8-10 fractions schedules with Helical Tomotherapy (HT) for primary and metastatic lung lesions. METHODS: Between March 2014 and May 2016, a total of 39 patients (median age 72 years, range 26-91) were treated with HT-SBRT for malignant lung lesions: 22 patients with early stage NSCLC, 17 with oligometastases...
February 17, 2018: La Radiologia Medica
Juyi Wen, Hongliang Liu, Lili Wang, Xiaomeng Wang, Ning Gu, Zhensheng Liu, Ting Xu, Daniel R Gomez, Ritsuko Komaki, Zhongxing Liao, Qingyi Wei
INTRODUCTION: Autophagy not only plays an important role in the progression of cancer but also is involved in tissue inflammatory response. However, few published studies have investigated associations between functional genetic variants of autophagy-related genes and radiation pneumonitis (RP) as well as clinical outcomes in patients with non-small cell lung cancer (NSCLC) after definitive radiotherapy. METHODS: We genotyped nine potentially functional single nucleotide polymorphisms (SNPs) in four autophagy-related genes (ATG2B, ATG10, ATG12 and ATG16L2) in 393 North American NSCLC patients treated by definitive radiotherapy and assessed their associations with RP, local recurrence-free survival (LRFS), progression-free survival (PFS) and overall survival (OS) in multivariable Cox proportional hazards regression analyses...
February 15, 2018: Journal of Thoracic Oncology
Kuai-Le Zhao, Yi Xia, Yun-Hai Li, Yun Chen, Qi Liu, Jun-Hua Zhang, Jia-Ying Deng, Ta-Shan Ai, Han-Ting Zhu, Harun Badakhshi
BACKGROUND: This study was performed to assess the efficacy and feasibility of definitive chemoradiotherapy consisting of weekly doses of combined paclitaxel and carboplatin concurrent with radiation therapy, followed by 2 cycles of consolidation chemotherapy for advanced esophageal carcinoma. METHODS: Eligibility criteria included local, advanced, newly diagnosed and postoperative local regional lymph node metastasis; Eastern Cooperative Oncology Group (ECOG) score ≤ 2; and adequate organ function...
February 12, 2018: International Journal of Clinical Oncology
Lehui Du, Wei Yu, Xiangkun Dai, Nana Zhao, Xiang Huang, Fang Tong, Fang Liu, Yurong Huang, Zhongjian Ju, Wei Yang, Xiaohu Cong, Chuanbin Xie, Xiaoliang Liu, Lanqing Liang, Yanan Han, Baolin Qu
A total of 149 lung cancer patients were recruited to receive intensity modulated radiation therapy (IMRT). The association of developing radiation pneumonitis (RP) with genetic polymorphism was evaluated. The risks of four polymorphic sites in three DNA repair related genes (ERCC1, rs116615:T354C and rs3212986:C1516A; ERCC2, rs13181:A2251C; XRCC1, rs25487:A1196G) for developing grade ≥ 2 RP were assessed respectively. It was observed that ERCC1 T354C SNP had a significant effect on the development of grade ≥ 2 RP (CT/TT vs...
January 2, 2018: Oncotarget
S N Sunilgowda, Devipriya Nagarajan, Devipriya Nagarajan
Radiotherapy is the most widely used treatment method for average and advanced lung cancer patients. Moreover, the clinical toxicities caused by radiotherapy are categorized into acute radiation pneumonitis and late pulmonary fibrosis. Epithelial-mesenchymal transition (EMT) is a complex physiological process involves many signaling molecules and proteins like adaptor proteins, and transcriptional factors. It was identified as a significant mechanism for fibrosis, wound healing and also cancer. A variety of biomarkers have appeared in radiation-induced lung EMT, some of which are acquired (N-cadherin, vimentin and fibronectin, etc...
February 6, 2018: Current Drug Targets
Takashi Ono, Tatsuya Nakamura, Hisashi Yamaguchi, Yusuke Azami, Kanako Takayama, Motohisa Suzuki, Hitoshi Wada, Yasuhiro Kikuchi, Masao Murakami, Kenji Nemoto
BACKGROUND: The purpose of the present study was to evaluate retrospectively the efficacy and safety of proton beam therapy for elderly patients (≥80 years of age) with non-small cell lung cancer. METHODS: Patients diagnosed with T1-4 N0 M0 non-small cell lung cancer and treated with proton beam therapy between January 2009 and 2015 were recruited from our database retrospectively. Toxicity was evaluated using The Common Terminology Criteria for Adverse Events version 4...
February 5, 2018: Radiation Oncology
Hyun Mi Kim, Suk Hee Kim, Bo Sun Kang
BACKGROUND/OBJECTIVES: Exposure of the normal lung tissue around the cancerous tumor during radiotherapy causes serious side effects such as pneumonitis and pulmonary fibrosis. Radioprotectors used during cancer radiotherapy could protect the patient from side effects induced by radiation injury of the normal tissue. Delphinidin has strong antioxidant properties, and it works as the driving force of a radioprotective effect by scavenging radiation-induced reactive oxygen species (ROS)...
February 2018: Nutrition Research and Practice
V Sarradin, L Simon, A Huynh, J Gilhodes, T Filleron, F Izar
PURPOSE: Helical TomoTherapy® allows precise and homogeneous tumour coverage and excellent sparing of organs at risk. We present here our treatment technique, dosimetric results, and our first clinical data for patients receiving total body irradiation as part of the conditioning regimen before hematopoietic stem cell transplantation. PATIENTS AND METHODS: The cohort consisted of 11 patients who were treated in our institution between August 2014 and January 2016...
January 25, 2018: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Tetsuhiko Taira, Kiyotaka Yoh, Seisuke Nagase, Kaoru Kubota, Hironobu Ohmatsu, Seiji Niho, Masakatsu Onozawa, Tetsuo Akimoto, Yuichiro Ohe, Koichi Goto
PURPOSE: The purpose of this phase I/II study was to evaluate the feasibility and efficacy of S-1 plus cisplatin at the recommended schedule with concurrent thoracic radiotherapy for locally advanced non-small cell lung cancer (LA-NSCLC). METHODS: Eligible patients with LA-NSCLC were treated with cisplatin intravenously at a dose of 60 mg/m2 on day 8 plus oral S-1 at a dosage of 40 mg/m2 twice per day for two different treatment schedules for up to 4 cycles. Patients also concurrently received 60 Gy of thoracic radiation in 30 fractions...
January 31, 2018: Cancer Chemotherapy and Pharmacology
Kakeru Hisakane, Kiyotaka Yoh, Naoki Nakamura, Hibiki Udagawa, Keisuke Kirita, Shigeki Umemura, Shingo Matsumoto, Seiji Niho, Tetsuo Akimoto, Masahiro Tsuboi, Koichi Goto
Although a few investigators have demonstrated the effect of concurrent chemoradiotherapy (CRT) for postoperative recurrent non-small cell lung cancer (NSCLC), the outcome of this treatment remains unclear. The aim of this study was to elucidate the efficacy and tolerability of concurrent CRT with cisplatin (CDDP) and vinorelbine (VNR) in patients with postoperative locoregional recurrent NSCLC. A total of 40 patients who had received concurrent CRT with CDDP and VNR between January 1999 and December 2014 were retrospectively analyzed...
November 2017: Medicine (Baltimore)
Hyo-Cheol Kim, Yoon Jun Kim, Jin Chul Paeng, Jin Wook Chung
PURPOSE: To address the feasibility of infusion of yttrium-90 (90Y) glass microspheres directly through the right inferior phrenic artery (RIPA). MATERIALS AND METHODS: From November 2015 to May 2017, 20 patients underwent 90Y radioembolization through the RIPA. When the systemic-to-pulmonary shunt was demonstrated on C-arm computed tomography (CT) of the RIPA, prophylactic embolization by polyvinyl alcohol (PVA) particles was performed prior to infusion of 90Y glass microspheres...
January 17, 2018: Journal of Vascular and Interventional Radiology: JVIR
Nadya Shusharina, Zhongxing Liao, Radhe Mohan, Amy Liu, Andrzej Niemierko, Noah Choi, Thomas Bortfeld
BACKGROUND AND PURPOSE: To compare lung injury among non-small cell lung cancer (NSCLC) patients treated with IMRT or proton therapy as revealed by18 F-FDG post-treatment uptake and to determine factors predictive for clinically symptomatic radiation pneumonitis. MATERIAL AND METHODS: For 83 patients treated with IMRT or proton therapy, planning CT and follow up18 F-FDG PET-CT were analyzed. Post-treatment PET-CT was aligned with planning CT to establish a voxel-to-voxel correspondence between PET and planning dose images...
January 15, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Shanaz A Ghandhi, Helen C Turner, Igor Shuryak, Gregory O Dugan, J Daniel Bourland, John D Olson, Janet A Tooze, Shad R Morton, Ines Batinic-Haberle, J Mark Cline, Sally A Amundson
We investigated the cytogenetic and gene expression responses of peripheral blood cells of non-human primates (NHP, Macaca mulatta) that were whole-thorax irradiated with a single dose of 10 Gy. In this model, partial irradiation of NHPs in the thoracic region (Whole Thorax Lung Irradiation, WTLI) allows the study of late radiation-induced lung injury, while avoiding acute radiation syndromes related to hematopoietic and gastrointestinal injury. A transient drop in circulating lymphocytes and platelets was seen by 9 days, followed by elevations in respiratory rate, circulating neutrophils, lymphocytes, and monocytes at 60-100 days, corresponding to computed tomography (CT) and histologic evidence of pneumonitis, and elective euthanasia of four animals...
2018: PloS One
Mark D Sternlicht, Ute Wirkner, Sebastian Bickelhaupt, Ramon Lopez Perez, Alexandra Tietz, Kenneth E Lipson, Todd W Seeley, Peter E Huber
BACKGROUND: Fibrosis is a delayed side effect of radiation therapy (RT). Connective tissue growth factor (CTGF) promotes the development of fibrosis in multiple settings, including pulmonary radiation injury. METHODS: To better understand the cellular interactions involved in RT-induced lung injury and the role of CTGF in these responses, microarray expression profiling was performed on lungs of irradiated and non-irradiated mice, including mice treated with the anti-CTGF antibody pamrevlumab (FG-3019)...
January 18, 2018: Respiratory Research
Angela M Groves, Carl J Johnston, Jacqueline P Williams, Jacob N Finkelstein
Lung exposure to radiation induces an injury response that includes the release of cytokines and chemotactic mediators; these signals recruit immune cells to execute inflammatory and wound-healing processes. However, radiation alters the pulmonary microenvironment, dysregulating the immune responses and preventing a return to homeostasis. Importantly, dysregulation is observed as a chronic inflammation, which can progress into pneumonitis and promote pulmonary fibrosis; inflammatory monocytes, which are bone marrow derived and express CCR2, have been shown to migrate into the lung after radiation exposure...
January 13, 2018: Radiation Research
Neha P Amin, Adrian Nalichowski, Shauna Campbell, Jal Hyder, Robyn Spink, Andre A Konski, Michael Dominello
PURPOSE: We observed that many of our helical therapy lung stereotactic body radiation therapy plans did not meet the Radiation Therapy Oncology Group (RTOG) recommended R50% (volume of 50% of the prescription dose/planning target volume), which characterizes the steepness of dose fall off. We hypothesized that despite not meeting R50%, helical therapy lung stereotactic body radiation therapy plans would confer similar local control and minimal side effects as previously reported using nonhelical treatment platforms...
December 2017: Technology in Cancer Research & Treatment
Tunc Ones, Emel Eryuksel, Feyyaz Baltacioglu, Berrin Ceyhan, Tanju Yusuf Erdil
BACKGROUND: Selective internal radiation therapy (SIRT) with embolization of branches of the hepatic artery is a valuable therapeutic tool for patients with hepatic malignancies; however, it is also associated with lung injury risk due to shunting. Diffusion capacity of the lungs for carbon monoxide (DLCO) is a clinically significant lung function test, and worsening in DLCO is suggested to reflect a limited gas exchange reserve caused by the potential toxicity of chemoradiotherapy or it may be a marker of related lung injury...
December 29, 2017: EJNMMI Research
Meng Qin, Weijuan Chen, Juanjuan Cui, Wentao Li, Dongmei Liu, Weifen Zhang
Radiation pneumonitis is a clinical problem with a high incidence. Once the onset of radiation pneumonitis has occurred, the administration of antioxidants and anti-inflammatory agents is the most commonly used method of clinical treatment. Quercetin (Que) is a common flavonoid, with potent anti-inflammatory and anti-oxidant activities. In the present study, the therapeutic effect of inhaled Que on radiation-induced radiation pneumonitis in rats was investigated. Treatment with Que via inhalation was shown to increase the number of leukocytes and erythrocytes in the blood, and reduce the number of inflammatory cells in bronchoalveolar lavage fluid...
December 2017: Experimental and Therapeutic Medicine
Sameera Kumar, Jonathan Feddock, Xingzhe Li, Andrew J Shearer, Logan Hall, Brent J Shelton, Susanne Arnold, Ronald C McGarry
PURPOSE: To report long-term outcomes (risk of late toxicities, local control, and survival) of dose escalation by stereotactic radiation therapy boost to residual fluorodeoxyglucose positron emission tomography-positive residual disease after chemoradiation (CRT) in stage III non-small cell lung cancer (NSCLC). METHODS AND MATERIALS: Patients with stage IIB/III NSCLC underwent computed tomography or positron emission tomography-computed tomography screening approximately 1 month after completion of CRT...
November 1, 2017: International Journal of Radiation Oncology, Biology, Physics
Yuki Hosono, Nobuhiko Sawa, Saeko Nakatsubo, Mikako Ishijima, Takeshi Uenami, Masaki Kanazu, Yuki Akazawa, Yukihiro Yano, Masahide Mori, Toshihiko Yamaguchi, Soichiro Yokota
A 59-year-old woman suffering from dry cough and dyspnea was admitted to our hospital. She had undergone concurrent chemo-radiotherapy five months earlier. Chest computed tomography revealed bilateral ground-glass opacities extending outside the irradiated lung field. Her eosinophil numbers were increased in both the peripheral blood and the bronchoalveolar lavage fluid; therefore, she was diagnosed with radiation pneumonitis accompanied by eosinophilic alveolitis. Steroid therapy promptly improved the pneumonitis...
December 27, 2017: Internal Medicine
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