| Xu Ke,Zhao Jinxin,Liu Zezhou,Liang Yansong,Cao Guohui,Liu Xiaoli,Di Yan,Wang Juan,Zhang Hongtao.Dosimetric analysis of radiation pneumonitis induced by 125I seed implantation for the treatment of malignant lung tumors[J].Chinese Journal of Radiological Medicine and Protection,2024,44(1):13-17 |
| Dosimetric analysis of radiation pneumonitis induced by 125I seed implantation for the treatment of malignant lung tumors |
| Received:May 11, 2023 |
| DOI：10.3760/cma.j.cn112271-20230511-00142 |
| KeyWords:Radiation pneumonitis Lung tumor Brachytherapy Dosimetric parameter |
| FundProject:河北省重点研发计划项目(19277767D) |
| Author Name | Affiliation | E-mail | | Xu Ke | Hebei Provincial Tumor Radioactive Seeds Implantation Diagnosis and Treatment Center, Hebei Provincial Radioactive Seeds Brachytherapy Institute, First Oncology Department of Hebei Provincial People's Hospital, Shijiazhuang 050051, China | | | Zhao Jinxin | Hebei Provincial Tumor Radioactive Seeds Implantation Diagnosis and Treatment Center, Hebei Provincial Radioactive Seeds Brachytherapy Institute, First Oncology Department of Hebei Provincial People's Hospital, Shijiazhuang 050051, China | | | Liu Zezhou | Hebei Provincial Tumor Radioactive Seeds Implantation Diagnosis and Treatment Center, Hebei Provincial Radioactive Seeds Brachytherapy Institute, First Oncology Department of Hebei Provincial People's Hospital, Shijiazhuang 050051, China | | | Liang Yansong | Hebei Provincial Tumor Radioactive Seeds Implantation Diagnosis and Treatment Center, Hebei Provincial Radioactive Seeds Brachytherapy Institute, First Oncology Department of Hebei Provincial People's Hospital, Shijiazhuang 050051, China | | | Cao Guohui | Hebei Provincial Tumor Radioactive Seeds Implantation Diagnosis and Treatment Center, Hebei Provincial Radioactive Seeds Brachytherapy Institute, First Oncology Department of Hebei Provincial People's Hospital, Shijiazhuang 050051, China | | | Liu Xiaoli | Hebei Provincial Tumor Radioactive Seeds Implantation Diagnosis and Treatment Center, Hebei Provincial Radioactive Seeds Brachytherapy Institute, First Oncology Department of Hebei Provincial People's Hospital, Shijiazhuang 050051, China | | | Di Yan | Hebei Provincial Tumor Radioactive Seeds Implantation Diagnosis and Treatment Center, Hebei Provincial Radioactive Seeds Brachytherapy Institute, First Oncology Department of Hebei Provincial People's Hospital, Shijiazhuang 050051, China | | | Wang Juan | Hebei Provincial Tumor Radioactive Seeds Implantation Diagnosis and Treatment Center, Hebei Provincial Radioactive Seeds Brachytherapy Institute, First Oncology Department of Hebei Provincial People's Hospital, Shijiazhuang 050051, China | | | Zhang Hongtao | Hebei Provincial Tumor Radioactive Seeds Implantation Diagnosis and Treatment Center, Hebei Provincial Radioactive Seeds Brachytherapy Institute, First Oncology Department of Hebei Provincial People's Hospital, Shijiazhuang 050051, China | hongtaozhangmd@163.com |
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| Abstract:: |
| Objective To investigate the incidence of radiation pneumonitis (RP) induced by 125I seed implantation for the treatment of malignant lung tumors and analyze related dosimetric parameters. Methods A retrospective analysis was conducted on 31 cases of malignant lung tumors treated with 125I seed implantation from January 2017 to December 2022 at Hebei Provincial Tumor Radioactive Seeds Implantation Diagnosis and Treatment Center. These cases consisted of eight patients with squamous cell carcinoma, 10 patients with adenocarcinoma, and 13 patients with metastatic cancer in other sites. At 1-6 months after treatment, these patients received postoperative chest CT scans, with the efficacy evaluated based on the Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1), including the objective response rate (ORR) and the disease control rate (DCR). The efficacy of RP was evaluated using the Radiation Therapy Oncology Group (RTOG) criteria. Postoperative dosimetric parameters, including D90 (minimum peripheral dose received by 90% of the target volume), V8 (percentage of lung volume receiving 8 Gy), V32 (percentage of lung volume receiving 32 Gy), and Dmean (mean radiation dose) of the affected lung, were statistically analyzed. The relationships of the RP occurrence with postoperative D90, V8, V32, and Dmean were analyzed by comparison with relevant external radiotherapy data, to identify the parameters that are correlated closely with RP occurrence. Results All the patients underwent successful surgeries. The postoperative efficacy evaluation after six months showed complete response (CR) in 11 cases, partial response (PR) in 11 cases, stable disease (SD) in eight cases, and progressive disease (PD) in one case, with an overall response rate (ORR) of 71.0%, and a disease control rate (DCR) of 96.8%. Three patients suffered RP, with an incidence rate of 9.7%. Postoperative V8, V32, and Dmean could not serve as predictive indicators for RP. Follow-up observation revealed that three RP cases (3/5) exhibited postoperative D90 exceeding 170 Gy and no RP cases (0/26) showed postoperative D90 below 170 Gy. Conclusions In the treatment of malignant lung tumors with 125I seed implantation, there is a certain correlation between RP and postoperative D90, while there is no correlation between it and V8, V32, and Dmean. |
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