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Estimating the Risk of Radiation Pneumonitis in Elderly Patients With Lung Cancer
Dirk Rades1,2, Laura Doehring2, Cansu Delikanli2
1Department of Radiation Oncology, University of Lübeck, Lübeck, Germany; dirk.rades@uksh.de.
Background/Aim:
Pneumonitis is a potential complication following radiotherapy of lung cancer, particularly in elderly patients. We developed a risk score for this age group.
Patients And Methods:
Thirteen factors were investigated in 124 elderly lung cancer patients. Factors significantly associated with symptomatic radiation pneumonitis (RP) or showing a trend were used for the score, which was compared to an existing tool created in patients of any age.
Results:
RP was significantly associated with mean lung dose (MLD). Trends were found for autoimmune disease and cardiovascular disease. Based on these three factors, four risk groups were designed (6-7, 8-9, 11-12, and 14 points). RP rates were 0.0% (0/25), 19.1% (9/47), 51.1% (24/47), and 80.0% (4/5). Positive (PPV) and negative (NPV) predictive values were 80.0% and 100.0%. When using the existing tool based on MLD and autoimmune disease, PPV and NPV were the same.
Conclusion:
The new score was highly accurate but not superior to the existing tool. The existing tool appears preferable, since it requires only two variables.
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