Table 1.
Dosimetric and biological parameters in radiation-induced lung toxicity.
| Parameters | Risk increase | References | |
|---|---|---|---|
| Patients characteristics | Age | over 65 | (41–46) |
| Gender | female | (44, 47, 48) | |
| Smoking | non-smokers | (43, 48–53) | |
| Pre-existing lung diseases | ECOG performance 3–4 | (45, 46, 54–62) | |
| Genetic predisposition | SNPs in various genes | (63–74) | |
| Tumor location | Base, the upper half of the lung, the region adjacent to the pleura | (51, 70, 75–79) | |
| Low KPS | Radiation pneumonitis | (41, 48, 77, 78) | |
| Dosimetric parameters | Chemotherapy | Most chemotherapies | (41, 46, 48, 56, 61, 79–90) |
| Chemo-XRT schedule: | Sequential > concurrent fraction size >2.67 Gy | (46, 48, 61, 83, 91) | |
| Targeted therapies | TKI monotherapy and with RT | (92–96) | |
| Mean Lung Dose (MLD) | Higher MLD | (97–103) | |
| Dose to the heart | Undetermined | (104, 105) |
Patient's characteristics (age, gender, smoking status, pulmonary status, genetic predisposition) and dosimetric parameters (chemotherapy, radiotherapy, tumor location, lung volume, NTCP, MLD) affect the probability of radiation-induced lung toxicity. >, major; NTCP, normal tissue complication probability; MLD, mean lung dose.