Pulmonary toxicity of craniospinal irradiation using helical tomotherapyopen access
- Authors
- Lee, Joongyo; Kim, Euidam; Kim, Nalee; Suh, Chang-Ok; Chung, Yoonsun; Yoon, Hong In
- Issue Date
- Feb-2022
- Publisher
- NATURE PORTFOLIO
- Citation
- SCIENTIFIC REPORTS, v.12, no.1, pp.1 - 9
- Indexed
- SCIE
SCOPUS
- Journal Title
- SCIENTIFIC REPORTS
- Volume
- 12
- Number
- 1
- Start Page
- 1
- End Page
- 9
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/139485
- DOI
- 10.1038/s41598-022-07224-1
- ISSN
- 2045-2322
- Abstract
- Craniospinal irradiation using helical tomotherapy (HT-CSI) has advantages in aspects of homogeneous dose distribution. Physicians, however, still have concerns of pulmonary toxicity due to HT-CSI's relatively large, low-dose irradiated volume from continuous and 360 degrees rotation delivery. In this study, we investigated the pulmonary toxicity of HT-CSI. We retrospectively reviewed 105 patients who received HT-CSI between January 2014 and December 2019. Grade 2 + pulmonary toxicities were evaluated. Intensive systemic treatment was defined as systemic treatment administration before, during, and after HT-CSI. V-X Gy was defined as % volume receiving >= X Gy. Thirteen patients (12.4%) presented with grade 2 + pulmonary toxicities after HT-CSI. Of these patients, only one experienced grade 2 radiation pneumonitis combined with pembrolizumab-induced pneumonitis. Conversely, pneumonia was observed in 12 patients. Intensive systemic treatment (p = 0.004), immunosuppressive drugs (p = 0.031), and bilateral lung V-5 Gy >= 65% (p = 0.031) were identified as independent risk factors for pneumonia. The risk factor for pneumonia in pediatric patients were immunosuppressive drugs (p = 0.035) and bilateral lung V-5 Gy >= 65% (p = 0.047). HT-CSI can be a safe treatment modality with tolerable pulmonary toxicities. Intensive systemic treatment, immunosuppressive drugs, and bilateral lung V-5 Gy >= 65% were significantly associated with pneumonia. In these patients, close follow-up should be considered for proper management of pneumonia.
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