The role of dose volume histograms and TGF-β in the prediction of radiation pneumonitis: a pilot study

Abstract

OBJECTIVES To evaluate the role of some parameters of dose volume histograms (DVH) and plasma TGF-β levels in predicting radiation pneumonitis in non-small cell lung cancer (NSCLC) patients. METHODS Fifteen NSCLC patients treated with 3D conformal radiotherapy were included in the study. Radiotherapy dose was a median 60 Gy. Mean lung dose (MLD), V20 and V30 were calculated from both ipsilateral and contralateral lung DVH. TGF-β levels were studied with ELISA. RESULTS Median follow-up was 16 months (range 10-55). Radiation pneumonitis was diagnosed in three patients (6, 9, 12 months). Dose parameters of ipsi- and contralateral lungs revealed that higher MLD, V20, V30 values in contralateral lung were statistically significant for pneumonitis (p

Keywords

• Transforming Growth Factor beta,Radiation Pneumonitis,Radiotherapy, Conformal,Radiotherapy Dosage

Radyasyon pnömonisinin öngörülmesinde doz volüm histogramları ve TGF-β'nın yeri: Pilot çalışma

Öz

AMAÇ Torasik radyoterapi uygulanan küçük hücreli olmayan akciğer kanserli (KHOAK) hastalarda, radyasyon pnömonisi riski ile doz volüm histogramları (DVH) parametreleri ve plazma T G F -βseviyelerinin korelasyonu araştırıldı. GEREÇ VE YÖNTEM Bu çalışmaya üç boyutlu konformal radyoterapi uygulanan 15 KHOAK hastası dahil edildi. Radyoterapi dozu 50-66 Gy arası nda değişmekte olup, medyan doz 60 Gy idi. Olguların tümünde ipsilateral ve kontrlateral akciğerler için DVH'larından elde edilen MLD, V20, V30 değerleri incelendi. TGF-β seviyeleri ELISA yöntemi ile değerlendirildi. BULGULAR Olguların medyan takip süresi 16 ay idi (aralık 6-55). Bu süre içerisinde radyasyon pnömonisi üç olguda saptandı (1.,6. ve 9. aylarda). İpsilateral ve kontrlateral akciğerlerin doz par am e tr el eri karşılaştırıldığında, kontrlateral akciğ erlerin MLD, V20 ve V30 değerlerinin yüksek oluşu pnömoni gelişimi açısından anlamlı bulundu (p < 0,005). TGF-β seviyeleri pnömoni gelişimi için anlamlı bulunmadı. SONUÇ Yüksek kontrlateral akciğer dozunun (MLD, V2 0, V3 0) radyasyon pnömonisi gelifliminde risk faktörü olabileceği gösterilmiştir. TGF-β seviyeleri radyoterapi sonrası erken dönemde pnömoni riskini göstermede faydalı olmamıştır.

Anahtar Kelimeler

• Doz volüm histogramı, radyasyon pnömonisi, MLD, V20, V20, TGF-β

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