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• W2895860485 abstract "Pulmonary dosimetric parameters are correlated with physician reported common terminology criteria for adverse events (CTCAE) grade of radiation pneumonitis (RP). However, the correlation between CTCAE toxicity grade and pulmonary function test (PFT) changes is not well characterized. Additionally, long-term PFT outcomes are limited in the intensity-modulated radiotherapy (IMRT) era. In this report, we review CTCAE pulmonary data from lung cancer patients treated with IMRT and correlate them with 1) subacute PFTs change and 2) long term PFT changes. Between 05/2008 and 10/2015, lung cancer patients treated with IMRT with baseline and serial post-radiation pulmonary function tests (PFTS) were identified. Baseline patient characteristics, treatment details, and subacute and late toxicities (CTCAE and PFT changes) were recorded. CTCAE grade ≥ 2 RP was defined as symptomatic radiation changes requiring steroid medications within 12 months following radiation, unrelated to COPD or other medical comorbidities. Post-treatment PFTs were normalized to baseline PFTs and the relative declines were reported in < 6 month and >12 month time intervals, which were the time intervals representative of the subacute and chronic settings, respectively. Correlation between the development of Grade ≥ 2 RP and subacute (<6 months) and late changes (>12 months) in PFTs were assessed using a Student’s t-test. Baseline and post-treatment PFTs were available for 188 patients. Concurrent chemotherapy was given in 87% of patients and 4% received induction chemotherapy. Baseline COPD (FEV1/FVC<0.7) was present in 53% of patients. CTCAE Grade ≥ 2 RP toxicity was recorded in 10.6% of patients. The mean time to development of RP was 4.4 ± 2.4 months. PFT changes stratified by the development of CTCAE Grade ≥ 2 RP are displayed in Table 1. In the subacute timeframe, patients who developed Grade ≥ 2 RP had statistically significant greater declines in DLCO (30% vs 14%, p= 0.002), FEV1 (11% vs 1%, p=0.03), and FVC (10% vs 0%, p= 0.049) compared to patients without RP reactions. In the chronic timeframe, statistically significant greater declines in FVC (11% vs +3%, p=0.01) remained while DLCO (25% vs 13% p-value: 0.13) and FEV1 (9% vs 0% p= 0.18) were no longer significant, but demonstrated a trend toward greater declines. CTCAE Grade ≥ 2 RP toxicity correlated with declines in PFTs in the subacute timeframe, suggesting that CTCAE subacute toxicity may be an appropriate surrogate for PFT declines. Additionally, these data suggest there may be a correlation between subacute RP and late PFT decline.Abstract TU_27_3591; Table 1VariablePre-RT (% Pred ± SD)p<6 months post RT (Relative change ± SD)p12 months post RT (Relative change ± SD)pDLCORP No RP76 ± 26 80 ± 19NSRP No RP↓30% ± 4% ↓14% ± 2%0.002RP No RP↓25% ± 7% ↓13% ± 3%0.13FEV1RP No RP72 ± 23 75 ± 21NSRP No RP↓11% ± 4% ↓1% ± 2%0.03RP No RP↓9% ± 6% ↓0% ± 3%0.18FVCRP No RP82 ± 20 87 ± 18NSRP No RP↓10% ± 4% 0% ± 2%0.049RP No RP↓11% ± 4% ↑3% ± 3%0.01 Open table in a new tab" @default.
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• W2895860485 date "2018-11-01" @default.
• W2895860485 modified "2023-09-25" @default.
• W2895860485 title "Pulmonary Function Trends Following Modern Radiation Therapy: Association of CTC Provider Assessment with Subacute and Late PFT Changes" @default.
• W2895860485 doi "https://doi.org/10.1016/j.ijrobp.2018.07.1839" @default.
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