Cella, Laura Liuzzi, Raffaele D’Avino, Vittoria Conson, Manuel Picardi, Marco Pugliese, Novella Salvatore, Marco Pacelli, Roberto Di Biase, Angela Solla, Raffaele Pulmonary damage in Hodgkin's lymphoma patients treated with sequential chemo-radiotherapy: Predictors of radiation-induced lung injury <div><p></p><p><i>Background.</i> 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. <i>Material and methods.</i> 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. <i>Results.</i> 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. <i>Conclusion.</i> 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.</p></div> cutoff value;lymphoma patients;rt;multivariate analyses;rtog;RILI;roc;regression analyses;10 months;lung injury;Median patient age;receiver operator;ci;Lung Disease;cutoff values;26 years;curve analysis;lung dosimetric parameters;lung CT changes;Pulmonary damage;supradiaphragmatic radiation therapy;HL patients;lung radiological changes 2014-05-01
    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
10.6084/m9.figshare.1623085.v1