Sensitivity analysis for radiation-induced lung injury caused by radiotherapy for lung cancer patients in Tibetan Plateau, China / 中华放射肿瘤学杂志

ABSTRACT

Objective To investigate the factors associated with radiation-induced lung injury (RILI) caused by radiation therapy for lung cancer patients in Tibetan Plateau,China.Methods A total of 262 patients with non-small cell lung cancer (NSCLC) confirmed by pathology or cytology from April 2012 to February 2016,consisting of 138 native Tibetans living at an elevation over 3 000 meters and 124 non-native Tibetans or non-Tibetan people,were analysed.All patients received intensity-modulated radiotherapy ± chemotherapy and underwent CT follow-up for over 6 months.For patients with grade ≥ 2 RILI,the associations of ethnicity,age,sex,Kamofsky Performance Scale (KPS) score,clinical stage,chemotherapy,and smoking history with RILI were analyzed.For two groups of patients,native Tibetan population and non-native Tibetan population,the associations of sex,smoking history,chemotherapy,and radiation dose with RILI were analyzed.Radiation dose-volume parameters were compared using the chisquare test or's's exact test,and their correlations were analyzed using the Person correlation test;a multivariate analysis was performed using the logistic regression model.Results For the 262 NSCLC patients,ethnicity (P=0.040),sex (P=0.001),KPS score (P=0.026),presence or absence of smoking history (P =0.014),minimum lethal dose (P =0.037),V5 (P =0.000),and V20 (P=0.025)were found to be associated with the development of RILI.Further analysis showed that only the smoking history (P=0.013) was significantly correlated with demographic composition.And there was no significant relationship between radiation dose for different groups and the incidence of RILI (all P=＞ 0.05).Conclusions Native Tibetan patients with NSCLC are more susceptible to RILI.