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CT Density in Lung Cancer Patients After Radiotherapy Sensitized by Metoclopramide

A Subgroup Analysis of a Randomized Trial

CT-Dichte von Patienten mit Bronchialkarzinom nach Strahlentherapie in Kombination mit strahlensensitivierender Metoclopramidbehandlung. Subgruppenanalyse einer randomisierten Studie

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Abstract

Purpose:

To investigate the lung tissue response measured with computed tomography (CT) after radiotherapy (RT) combined with metoclopramide.

Patients and Methods:

Patients with non-small cell lung cancer (tumor stage IIIA and IIIB), included in a multicenter, randomized phase III trial investigating the use of metoclopramide as a radiosensitizing agent, were examined with repetitive post-RT CT scans. The analysis comprised data up to 100 days after RT for a subgroup of 16 patients treated with a total dose of 60 Gy given in 1.82 Gy per fraction.

Results:

Large radiation doses to subvolumes were associated with denser lung tissue measured with CT (p < 0.001). Opposed to this finding, the volume of lung tissue irradiated with significant doses (V40Gy) was negatively correlated with the average increase in lung tissue density (p = 0.003). Patients randomized to metoclopramide injections also experienced less increase in lung tissue density (p = 0.01).

Conclusion:

There was an increase in the density of irradiated lung tissue with radiation dose and time after RT. Metoclopramide and significant radiation doses to larger lung volumes (V40Gy) seemed to protect against fibrosis development.

Zusammenfassung

Ziel:

Computertomographische (CT) Messung der Strahlenreaktion in Lungengewebe nach Strahlentherapie in Kombination mit Metoclopramid.

Patienten und Methodik:

Patienten mit nichtkleinzelligem Bronchialkarzinom (Tumorstadium IIIA und IIIB), die in eine randomisierte, multizentrische Phase-III-Studie zur Untersuchung des strahlensensitivierenden Effekts von Metoclopramid eingeschlossen waren, wurden mittels wiederholter posttherapeutischer CTs untersucht. Verlaufskontrolldaten bis 100 Tage nach Beendigung der Strahlentherapie einer Untergruppe von 16 Patienten, die mit einer Gesamtdosis von 60 Gy, appliziert in Tagesdosen von 1,82 Gy, behandelt wurden, standen für die Analyse zur Verfügung.

Ergebnisse:

Hohe Strahlendosen auf Teilvolumina resultierten in höherer CT-Dichte im bestrahlten Lungengewebe (p < 0,001). Im Gegensatz dazu korrelierte das mit signifikanter Dosis bestrahlte Lungenvolumen (V40Gy) negativ mit der Zunahme der CTDichte im bestrahlten Lungengewebe (p = 0,003). Bei Patienten, die in den Therapiarm mit Metoclopramid randomisiert wurden, war eine weniger ausgeprägte Zunahme der CT-Dichte im bestrahlten Lungengewebe zu verzeichnen (p = 0,01).

Schlussfolgerung:

Es fand sich ein Zusammenhang zwischen der Zunahme der gemessenen CT-Dichte im bestrahlten Lungengewebe, der applizierten Strahlendosis und der Zeit nach Bestrahlung. Metoclopramid und das mit signifikanter Dosis bestrahlte Lungenvolumen (V40Gy) scheinen einen protektiven Effekt auf die Entwicklung einer Lungenfibrose zu haben.

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Authors and Affiliations

  1. Institute for Cancer Research, Oslo, Norway

    Einar Dale MD, PhD & Dag R. Olsen

  2. Cancer Clinic, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway

    Einar Dale MD, PhD & Øyvind Bruland

  3. Oslo University College, Oslo, Norway

    Vanja Hårsaker

  4. Norwegian Knowledge Center for the Health Services, Oslo, Norway

    Doris T. Kristoffersen

  5. University of Oslo, Oslo, Norway

    Øyvind Bruland & Dag R. Olsen

  6. Cancer Clinic, Rikshospitalet-Radiumhospitalet Medical Center, 0310, Oslo, Norway

    Einar Dale MD, PhD

Authors
  1. Einar Dale MD, PhD
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  2. Vanja Hårsaker
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  3. Doris T. Kristoffersen
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  4. Øyvind Bruland
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  5. Dag R. Olsen
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Correspondence to Einar Dale MD, PhD.

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Dale, E., Hårsaker, V., Kristoffersen, D.T. et al. CT Density in Lung Cancer Patients After Radiotherapy Sensitized by Metoclopramide. Strahlenther Onkol 186, 163–168 (2010). https://doi.org/10.1007/s00066-010-2040-6

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  • DOI: https://doi.org/10.1007/s00066-010-2040-6

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