Heart irradiation as a risk factor for radiation pneumonitis

Ellen X. Huang, Andrew J. Hope, Patricia E. Lindsay, Marco Trovo, Issam El Naqa, Joseph O. Deasy, Jeffrey D. Bradley

Research output: Contribution to journalArticle

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Abstract

Purpose. To investigate the potential role of incidental heart irradiation on the risk of radiation pneumonitis (RP) for patients receiving definitive radiation therapy for non-small-cell lung cancer (NSCLC). Material and methods. Two hundred and nine patient datasets were available for this study. Heart and lung dose-volume parameters were extracted for modeling, based on Monte Carlo-based heterogeneity corrected dose distributions. Clinical variables tested included age, gender, chemotherapy, pre-treatment weight-loss, performance status, and smoking history. The risk of RP was modeled using logistic regression. Results. The most significant univariate variables were heart related, such as heart heart V65 (percent volume receiving at least 65 Gy) (Spearman Rs 0.245, p <0.001). The best-performing logistic regression model included heart D10 (minimum dose to the hottest 10% of the heart), lung D35, and maximum lung dose (Spearman Rs 0.268, p <0.0001). When classified by predicted risk, the RP incidence ratio between the most and least risky 1/3 of treatments was 4.8. The improvement in risk modeling using lung and heart variables was better than using lung variables alone. Conclusions. These results suggest a previously unsuspected role of heart irradiation in many cases of RP.

Original languageEnglish
Pages (from-to)51-60
Number of pages10
JournalActa Oncologica
Volume50
Issue number1
DOIs
Publication statusPublished - Jan 2011

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Radiation Pneumonitis
Lung
Logistic Models
Non-Small Cell Lung Carcinoma
Weight Loss
Radiotherapy
Smoking
History
Drug Therapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Hematology

Cite this

Huang, E. X., Hope, A. J., Lindsay, P. E., Trovo, M., El Naqa, I., Deasy, J. O., & Bradley, J. D. (2011). Heart irradiation as a risk factor for radiation pneumonitis. Acta Oncologica, 50(1), 51-60. https://doi.org/10.3109/0284186X.2010.521192

Heart irradiation as a risk factor for radiation pneumonitis. / Huang, Ellen X.; Hope, Andrew J.; Lindsay, Patricia E.; Trovo, Marco; El Naqa, Issam; Deasy, Joseph O.; Bradley, Jeffrey D.

In: Acta Oncologica, Vol. 50, No. 1, 01.2011, p. 51-60.

Research output: Contribution to journalArticle

Huang, EX, Hope, AJ, Lindsay, PE, Trovo, M, El Naqa, I, Deasy, JO & Bradley, JD 2011, 'Heart irradiation as a risk factor for radiation pneumonitis', Acta Oncologica, vol. 50, no. 1, pp. 51-60. https://doi.org/10.3109/0284186X.2010.521192
Huang EX, Hope AJ, Lindsay PE, Trovo M, El Naqa I, Deasy JO et al. Heart irradiation as a risk factor for radiation pneumonitis. Acta Oncologica. 2011 Jan;50(1):51-60. https://doi.org/10.3109/0284186X.2010.521192
Huang, Ellen X. ; Hope, Andrew J. ; Lindsay, Patricia E. ; Trovo, Marco ; El Naqa, Issam ; Deasy, Joseph O. ; Bradley, Jeffrey D. / Heart irradiation as a risk factor for radiation pneumonitis. In: Acta Oncologica. 2011 ; Vol. 50, No. 1. pp. 51-60.
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