Observational Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 16, 2023; 11(5): 1040-1048
Published online Feb 16, 2023. doi: 10.12998/wjcc.v11.i5.1040
Multiple regression analysis of risk factors related to radiation pneumonitis
Ling-Ling Shi, Jiang-Hua Yang, Hong-Fa Yao
Ling-Ling Shi, Jiang-Hua Yang, Hong-Fa Yao, Department of Radiology, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou 313000, Zhejiang Province, China
Author contributions: Shi LL conceived and designed the study; Shi LL, Yang JH, and Yao HF collected the data and performed the analysis; Shi LL was involved in the writing of the manuscript and is responsible for the integrity of the study; all authors have read and approved the final manuscript.
Institutional review board statement: The Medical Ethics Association of Huzhou Central Hospital approved the study and obtained the informed consent from all enrolled patients (approval number: HZFY-L21035478; date: August 28, 2021).
Informed consent statement: Informed consent was obtained from all enrolled patients.
Conflict-of-interest statement: All authors declare no conflict of interest for this article.
Data sharing statement: The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hong-Fa Yao, BSc, Chief Technician, Department of Radiology, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, No. 1558 Sanhuan North Road, Huzhou 313000, Zhejiang Province, China. yhf817829@163.com
Received: August 30, 2022
Peer-review started: August 30, 2022
First decision: November 25, 2022
Revised: December 7, 2022
Accepted: January 20, 2023
Article in press: January 20, 2023
Published online: February 16, 2023
Abstract
BACKGROUND

Radiation pneumonitis (RP) is a severe complication of thoracic radiotherapy that may lead to dyspnea and lung fibrosis, and negatively affects patients’ quality of life.

AIM

To carry out multiple regression analysis on the influencing factors of radiation pneumonitis.

METHODS

Records of 234 patients receiving chest radiotherapy in Huzhou Central Hospital (Huzhou, Zhejiang Province, China) from January 2018 to February 2021, and the patients were divided into either a study group or a control group based on the presence of radiation pneumonitis or not. Among them, 93 patients with radiation pneumonitis were included in the study group and 141 without radiation pneumonitis were included in the control group. General characteristics, and radiation and imaging examination data of the two groups were collected and compared. Due to the statistical significance observed, multiple regression analysis was performed on age, tumor type, chemotherapy history, forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), carbon monoxide diffusion volume (DLCO), FEV1/FVC ratio, planned target area (PTV), mean lung dose (MLD), total number of radiation fields, percentage of lung tissue in total lung volume (vdose), probability of normal tissue complications (NTCP), and other factors.

RESULTS

The proportions of patients aged ≥ 60 years and those with the diagnosis of lung cancer and a history of chemotherapy in the study group were higher than those in the control group (P < 0.05); FEV1, DLCO, and FEV1/FVC ratio in the study group were lower than those in the control group (P < 0.05), while PTV, MLD, total field number, vdose, and NTCP were higher than in the control group (P < 0.05). Logistic regression analysis showed that age, lung cancer diagnosis, chemotherapy history, FEV1, FEV1/FVC ratio, PTV, MLD, total number of radiation fields, vdose, and NTCP were risk factors for radiation pneumonitis.

CONCLUSION

We have identified patient age, type of lung cancer, history of chemotherapy, lung function, and radiotherapy parameters as risk factors for radiation pneumonitis. Comprehensive evaluation and examination should be carried out before radiotherapy to effectively prevent radiation pneumonitis.

Keywords: Radiation pneumonitis, Influencing factors, Radiotherapy, Multiple regression analysis

Core Tip: Radiotherapy is a common treatment method for malignant tumors. However, it is associated with a high risk of radiation pneumonitis. Therefore, the early prevention of radiation pneumonitis is very important. We retrospectively compared medical records and analyzed the relevant clinical data of 234 patients with and without radiation pneumonitis to demonstrate that the risk factors for radiation pneumonitis include patient age, lung cancer diagnosis, history of chemotherapy, lung function, and radiotherapy parameters. Comprehensive evaluation and examination for each patient should be carried out before radiotherapy to effectively prevent radiation pneumonitis.