Author of

• 17783

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  P2.05 - Poster Session with Presenters Present (ID 463)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Radiotherapy
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 17837

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    P2.05-054 - Radiation Pneumonitis; Early Diagnosis and Protein Expression Profile in NSCLC Patients (ID 5375)

    14:30 - 14:30  |  Author(s): A. Montes
    • Abstract

    Background:
    Radiotherapy (RT) alone or in combination with chemotherapy (CT) are essential in treatment of non small cell lung cancer (NSCLC). A limitation for those therapies is the radiosensitivity of the lung. The aim of this study was to evaluate the incidence of radiation pneumonitis as well to identify potential markers for its early detection and to determine changes in the BAL protein expression.
    
    Methods:
    Fourteen NSCLC patients diagnosed at Multidisciplinary Lung Cancer Unit treated with chemotherapy-radiotherapy (CT-RT) or RT alone were enrolled in this prospective study. The collected variables were anthropometric values, lung function, tumor features and RT dosimetric data. A fiberopticbronchoscopy for bronchoalveolar lavage (BAL) was performed in both lungs before RT and at the third week of treatment. Radiation pneumonitis was scored according to the “Common Terminology Criteria for Adverse Events v4.0”. One patient with grade 1 pneumonitis and one patient with grade 3 pneumonitis were selected to perform the protein analysis using “Human Cytokine Array Panel A” (R&D Systems). The normality was determined with the Kolmogorov-Smirnov test. Student’s t-test was used when variables had a normal distribution. Differences were considered statistically significant when p values were < 0.05.
    
    Results:
    All patients develop radiation pneumonitis, 35.75% of patients developed grade 1 pneumonitis, 20% grade 2, 35.75% grade 3 and 6.66% grade 5. Four patients developed pneumonitis in the lung without tumour. The decrease in lung diffusion capacity for carbon monoxide (DLCO) was the most sensitive parameter for determining the existence of early lung damage (p=0.04). Development of radiation pneumonitis was not associated with baseline lung function neither RT dosimetric data. The BAL protein expression profile was different between the two patients before RT. Expression of PAI-1, IL-1ra, MIF, and CXCL-1 in patient with pneumonitis grade 1 were increased only in the lung with tumor however these proteins were also increased in patient with pneumonitis grade 3 but in both lungs. It was significant that in the 2 cases, RT induced similar changes in BAL protein expression in both lungs.
    
    Conclusion:
    In this prospective study, the incidence of radiation pneumonitis was greater than previously reported in the literature. The DLCO decline was the most sensitive parameter for its early detection. The risk to develop radiation pneumonitis appeared to be independent of dosimetric parameters and might be related with the baseline inflammatory state. According to BAL protein expression analysis, RT produced comparable molecular changes in both lungs. Funded by SEPAR and IDIBELL.