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

Yıl 2008, Cilt: 23 Sayı: 3, 109 - 119, 01.04.2008

Banu Atalar Fazilet Öner Dinçbaş Seval Aydın Hafize Uzun Sedat Koca

Öz

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

Anahtar Kelimeler

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

Kaynakça

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