Analysis of the risk factors of radiation pneumonitis and the predictive ability of dosiomics in non-small-cell lung cancer

Abstract

Purpose: This prospective study investigated the incidence of radiation pneumonitis (RP) after immunotherapy followed by radiotherapy in non-small-cell lung cancer, analyzed the risk factors for RP, and explored the predictive performance of dosimetry and dosiomics. Methods & materials: Risk factors for grade ≥2 RP were calculated by using a logistic regression model. Predictive performance was compared on the basis of area under the curve values. Results: Grade ≥2 RP occurred in 16 cases (26.7%). The AUC values of V_{5 Gy}, gray-level dependence matrix-small dependence high gray-level emphasis (GLDM-SDHGLE) and combined features were 0.685, 0.724 and 0.734, respectively. Conclusion: Smoking history, bilateral lung V_{5 Gy} and GLDM-SDHGLE were independent risk factors for RP. Dosiomics can effectively predict RP.

Keywords::

• dosiomics
• immunotherapy
• non-small-cell lung cancer
• pneumonitis prediction
• radiation pneumonitis
• radiotherapy

Author contributions

Conception and design: L Zhuang, X Bai, L Sheng, X Du. Collect patient information and follow-up: L Zhuang. Collection and assembly of data: L Zhuang, X Bai. Data analysis and interpretation: L Zhuang, X Bai, L Sheng. Manuscript writing: all authors. Final approval of manuscript: all authors. Accountable for all aspects of the work: all authors.

Acknowledgments

Thanks to the medical resources of Zhejiang Cancer Hospital for making my research possible. Thanks to all the teachers in the research team for their guidance. Thanks to every researcher who participated in this study.

Financial disclosure

The authors have no financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Competing interests disclosurew

The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, stock ownership or options and expert testimony.

Writing disclosure

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.