PORTage.

How do you estimate the risk of symptomatic radiation pneumonitis after adjuvant radiation for resected lung cancer? This is even more tricky with altered pulmonary volume and function after a lobectomy. In this analysis of 285 patients receiving post-op radiation (PORT) for lung cancer between 2004 and 2017—typically as part of trimodality therapy for node-positive disease—the overall rate of symptomatic radiation pneumonitis was 12.6%. Low-range lung dose, heart dose, carboplatin, and patient age were associated with even higher risk of radiation pneumonitis. In multivariate analysis, lung V5 and patient age were significant predictors of symptomatic pneumonitis. TBL: To reduce the risk of pneumonitis to < 5% when delivering PORT for lung cancer, this study suggests considering age in your calculation: V5 <65% for patients <65 years and a much more strict <36% for those 65+. | Shepherd, Pract Radiat Oncol 2020