Precision Radiation Oncology · Published 2025-09-01 · DOI 10.1002/pro6.70029
Abstract Purpose This study aimed to investigate the dose dependency of asymptomatic radiation pneumonitis (aRP) in patients with lung cancer following radiotherapy, focusing on the predictive value of dosimetric parameters. Methods This study included 72 patients with primary lung cancer who underwent radiotherapy between January 2019 and June 2022. The patients were divided into an aRP group (n = 30) and a non‐RP group (n = 42). The physical dose was converted to an equivalent dose using the Linear‐Quadratic (LQ) model, with an α/β value of 3. Three lung structures were defined, and the corresponding dose‐volume histogram parameters were collected. The Mann–Whitney U test was used to compare dose parameters between the two groups, and multivariate logistic regression was performed to remove correlations among different parameters. A logistic function and receiver operating characteristic curve were constructed to predict aRP. This study analyzed the impact of different clinical characteristics on the aRP incidence. Results The lungs‐planning target volume (PTV) V15(Gy) was ultimately identified as the best predictive parameter. Significant dose–response relationships were observed, with V15(Gy) achieving an area under the curve of 0.666 ± 0.067 (P = 0.017). The optimal cutoff value for lungs‐PTV V15(Gy) was 21.1%, below which the incidence of aRP decreased significantly. Immunotherapy has been identified as an independent risk factor for aRP. Conclusion The occurrence of aRP in patients with lung cancer after radiotherapy has a clear dose dependency, with lungs‐PTV, V15(Gy) being the best dose parameter for prediction, and the optimal cutoff value based on this study was 21.1%.
Abstract from DOAJ. Public domain (CC0 1.0).
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