• Atsuya Takeda, Toshio Ohashi, Etsuo Kunieda, Tatsuji Enomoto, Naoko Sanuki, Toshiaki Takeda, and Naoyuki Shigematsu.
• Department of Radiology, Ofuna Chuo Hospital, Kanagawa, Japan.
• Int. J. Radiat. Oncol. Biol. Phys. 2010 Jul 1;77(3):685-90.

PurposeTo investigate factors associated with Grade >or=3 radiation pneumonitis (RP) in patients with lung tumors treated with stereotactic body radiotherapy (SBRT).Methods And MaterialsWe retrospectively analyzed 128 patients with 133 lung tumors treated with SBRT. RP was graded according to the Common Terminology Criteria for Adverse Events version 3.0. Univariate analyses were used to identify predictive factors for RP.ResultsThe median follow-up period after SBRT was 12 months (range, 5-45 months). Incidences of Grades 0, 1, 2, and 3 RP were 27%, 52%, 16%, and 5%, respectively. No patients suffered Grade 4 or 5 RP. For all patients with Grade 2 or 3, symptoms occurred either simultaneously with or subsequent to graphical appearances. The latent period was the only significant factor associated with Grade >or=3 RP (p < 0.01). A latent period of 1 or 2 months indicated a 40% (6/15) risk for Grade 3. However, the risk for Grade 3 was 1.2% (1/82) 3 months after SBRT. No pretreatment clinical or dosimetric factors were significantly associated with Grade >or=3 RP. However, 4 of 7 patients with Grade 3 RP had severe pulmonary comorbidities.ConclusionOnly the latency period was a significant factor in the development of RP. No pretreatment clinical or dosimetric factors were significantly associated with Grade >or=3 RP. Patients, especially those with severe pulmonary comorbidities, should be carefully observed for the graphical appearance of RP within a few months during the follow-up period after SBRT.(c) 2010 Elsevier Inc. All rights reserved.

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