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A systematic review comparing radiation-induced pneumonitis in patients receiving CHART and conventional radiotherapy [Abstract]

Pritchard, J. and Williamson, Keren 2009. A systematic review comparing radiation-induced pneumonitis in patients receiving CHART and conventional radiotherapy [Abstract]. Clinical Oncology 21 (3) , p. 276. 10.1016/j.clon.2009.01.001

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Background With rapidly dividing lesions such as non-small cell lung cancer (NSCLC), repopulation of tumour cells during breaks in radiotherapy treatment is recognised as a prohibiting factor for effective tumour eradication. To address this, NICE guidelines advocate continuous hyperfractionated accelerated radiotherapy (CHART) as the standard regimen for the treatment of suitable stage I and II NSCLC. The CHART regimen is, however, more intensive than conventional radiotherapy fractionation and is associated with increased risk of treatment morbidity and radiation induced complications. One complication associated with radiation treatment of lung tissue is radiation induced pneumonitis (RP). This systematic review of literature aimed to compare the incidence and severity of RP in patients receiving CHART with patients receiving conventional fractionation radiotherapy treatment. Method A systematic review of current evidence-based literature was employed, with the scope of the study extending to include a variety of databases such as Medline, PubMED and the Cochrane Library. The evidence was then filtered in order to meet inclusion/exclusion criteria and relevance criteria. Findings A total of 10 studies met the criteria for inclusion in the final review. The main reasons for exclusion of studies included lack of relevance, no provision of quantitative or qualitative data with respect to incidence of RP or evidence of methodological flaws. The review showed decreased incidence of RP amongst patients receiving CHART compared with patients receiving conventional fractionation radiotherapy (13.2% to 19.7% respectively). The study also highlighted several key predicative factors for RP including Mean Lung Dose, volume of lung receiving a dose greater than 20Gy, gender, age and smoking habits. Conclusion A range of variables have an effect on the incidence of RP, of which treatment regimen is one. However, as other predicative factors are present multivariate models would need to be constructed in order to provide an accurate assessment of RP risk.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Healthcare Sciences
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
R Medicine > RM Therapeutics. Pharmacology
Additional Information: Supplement 1, Poster 53
Publisher: Elsevier
ISSN: 0936-6555
Last Modified: 04 Jun 2017 03:59

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