Fatal pneumonitis associated with intensity-modulated radiation therapy for mesothelioma: In regard to Allen et al. (Int J Radiat Oncol Biol Phys 2006;65:640–645)
2006; Elsevier BV; Volume: 66; Issue: 5 Linguagem: Inglês
10.1016/j.ijrobp.2006.09.005
ISSN1879-355X
AutoresRitsuko Komaki, Zhongxing Liao, Helen Liu, Susan L. Tucker, David C. Rice,
Tópico(s)Pleural and Pulmonary Diseases
ResumoThe article by Allen et al. ( 1 Allen A.M. Czerminska M. Janne P.A. et al. Fatal pneumonitis associated with intensity-modulated radiation therapy for mesothelioma. Int J Radiat Oncol Biol Phys. 2006; 65: 640-645 Abstract Full Text Full Text PDF PubMed Scopus (288) Google Scholar ) demonstrates that multidisciplinary approaches to treat thoracic malignancies requires less aggressive neoadjuvant or adjuvant treatment and more strict dose–volume constraints to avoid fatal toxicities. Fatal pneumonitis associated with intensity-modulated radiation therapy for mesotheliomaInternational Journal of Radiation Oncology, Biology, PhysicsVol. 65Issue 3PreviewPurpose: To describe the initial experience at Dana-Farber Cancer Institute/Brigham and Women’s Hospital with intensity-modulated radiation therapy (IMRT) as adjuvant therapy after extrapleural pneumonectomy (EPP) and adjuvant chemotherapy.Methods and Materials: The medical records of patients treated with IMRT after EPP and adjuvant chemotherapy were retrospectively reviewed. IMRT was given to a dose of 54 Gy to the clinical target volume in 1.8 Gy daily fractions. Treatment was delivered with a dynamic multileaf collimator using a sliding window technique. Full-Text PDF In response to Dr. Komaki et alInternational Journal of Radiation Oncology, Biology, PhysicsVol. 66Issue 5PreviewWe would like to thank our colleagues at M.D. Anderson Cancer Center (MDACC) for sharing their insights and experiences in the treatment of thoracic malignancies with intensity-modulate radiation therapy (IMRT). As stated in our article, we believe that a critical factor in the fatal cases of pneumonitis seen in our series was the high level of low-dose radiation therapy to the lung, as measured by V5 (1). As we mentioned in our Discussion, the MDACC group had published data from esophageal cancer that indicated that volume spared 5 Gy is an important factor and should be considered in the evaluation of treatment plans for thoracic IMRT (2, 3). Full-Text PDF
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