TY - DATA T1 - Pulmonary damage in Hodgkin's lymphoma patients treated with sequential chemo-radiotherapy: Predictors of radiation-induced lung injury PY - 2014/05/01 AU - Laura Cella AU - Raffaele Liuzzi AU - Vittoria D’Avino AU - Manuel Conson AU - Marco Picardi AU - Novella Pugliese AU - Marco Salvatore AU - Roberto Pacelli AU - Angela Di Biase AU - Raffaele Solla UR - https://tandf.figshare.com/articles/journal_contribution/Pulmonary_damage_in_Hodgkin_s_lymphoma_patients_treated_with_sequential_chemo_radiotherapy_Predictors_of_radiation_induced_lung_injury/1623085 DO - 10.6084/m9.figshare.1623085.v1 L4 - https://ndownloader.figshare.com/files/2606301 KW - cutoff value KW - lymphoma patients KW - rt KW - multivariate analyses KW - rtog KW - RILI KW - roc KW - regression analyses KW - 10 months KW - lung injury KW - Median patient age KW - receiver operator KW - ci KW - Lung Disease KW - cutoff values KW - 26 years KW - curve analysis KW - lung dosimetric parameters KW - lung CT changes KW - Pulmonary damage KW - supradiaphragmatic radiation therapy KW - HL patients KW - lung radiological changes N2 - Background. Our aim was to define predictors of late radiation-induced lung injury (RILI) in Hodgkin's lymphoma (HL) survivors treated with bleomycin-containing chemotherapy and radiotherapy. Material and methods. Eighty consecutive patients treated with chemotherapy and subsequent supradiaphragmatic radiation therapy for HL were retrospectively reviewed for symptoms and/or radiological signs of RILI. Median patient age was 26 years (range 14–55). Left, right, and total lung dosimetric parameters along with clinical, disease, and treatment-related characteristics were analyzed. Multivariate logistic regression analyses were performed. A receiver operator characteristic (ROC) curve analysis was performed to find possible cutoff values dividing patients into high- and low-risk groups. Results. Seven of 80 (9%) patients had lung disease at baseline. Four of 80 (5%) had toxicity after chemotherapy and before the beginning of radiotherapy. These patients were excluded from further evaluation. At a median time of 10 months (range 9–18), 9/69 patients (13%) developed lung radiological changes on computed tomography (CT) after treatment. Four of nine patients were diagnosed RTOG grade ≥ 2. On multivariate analyses, left-lung V30 (p = 0.004, OR = 1.108 95% CI 1.033–1.189) and total-lung V30 (p = 0.009, OR = 1.146 95% CI 1.035–1.270) resulted to be predictors of lung CT changes with a cutoff value of 16% and 15%, respectively. When only symptomatic RILI was considered a left-lung V30 cutoff value of 32% was estimated. Conclusion. Bleomycin and RT may cause lung injury in a small, but significant fraction of HL patients. Left-lung V30 predicts the risk of developing asymptomatic or symptomatic RILI after sequential chemo-radiotherapy. ER -