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
Processing time: 167 Days and 23.3 Hours
ARTICLE HIGHLIGHTS
Research background

Radiotherapy is a common treatment method for malignant thoracic tumors. However, it is associated with complications, such as radiation pneumonitis that is mainly caused by the radiation-induced damage to the pulmonary vascular endothelial cells and parenchymal cells. It can develop into chronic inflammation and pulmonary fibrosis and may reduce the effectiveness of the treatment and impact the quality of life of cancer patients.

Research motivation

Early prevention of radiation pneumonitis is very important. Clinical continuous comprehensive analysis of associated risk factors and the formulation of targeted preventative methods may reduce the incidence of this complication.

Research objectives

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

Research methods

Records of patients receiving chest radiotherapy between January 2018 to February 2021 were collected and divided into two groups according to whether radiation pneumonitis was diagnosed. Multiple regression analysis was performed on age, tumor type, chemotherapy history, forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), 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.

Research results

The proportions of patients with an age ≥ 60 years, lung cancer diagnosis, 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 those 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.

Research conclusions

The risk factors for radiation pneumonitis include patient age, lung cancer diagnosis, history of chemotherapy, lung function, and radiotherapy parameters.

Research perspectives

A comprehensive evaluation and examination should be carried out before beginning the radiotherapy treatment. Clinicians should fully consider all the influencing factors based on the individual situation of each patient, to design a scientific and reasonable radiotherapy plan.