Early Identification of Pneumonitis in Patients Irradiated for Lung Cancer—Final Results of the PARALUC Trial
Radiotherapy of lung cancer may cause pneumonitis that generally occurs weeks or months following therapy and can be missed. This prospective trial aimed to pave the way for a mobile application (app) allowing early diagnosis of pneumonitis. The primary goal was the identification of the optimal cut...
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MDPI AG
2023-01-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/2/326 |
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| author | Dirk Rades Elisa M. Werner Esther Glatzel Sabine Bohnet Steven E. Schild Søren S. Tvilsted Stefan Janssen |
| author_facet | Dirk Rades Elisa M. Werner Esther Glatzel Sabine Bohnet Steven E. Schild Søren S. Tvilsted Stefan Janssen |
| author_sort | Dirk Rades |
| collection | DOAJ |
| description | Radiotherapy of lung cancer may cause pneumonitis that generally occurs weeks or months following therapy and can be missed. This prospective trial aimed to pave the way for a mobile application (app) allowing early diagnosis of pneumonitis. The primary goal was the identification of the optimal cut-off of a score to detect pneumonitis of grade ≥2 after radiotherapy for lung cancer. Based on the severity of symptoms (cough, dyspnea, fever), scoring points were 0–9. Receiver operating characteristic (ROC)-curves were used to describe the sensitivity and specificity. The area under the ROC-curve (AUC) was calculated to judge the accuracy of the score, Youden-index was employed to define the optimal cut-off. Until trial termination, 57 of 98 patients were included. Eight of 42 patients evaluable for the primary endpoint (presence or absence of radiation pneumonitis) experienced pneumonitis. AUC was 0.987 (0.961–1.000). The highest sensitivity was achieved with 0–4 points (100%), followed by 5 points (87.5%), highest specificity with 5–6 points (100%). The highest Youden-index was found for 5 points (87.5%). The rate of patient satisfaction with the symptom-based scoring system was 93.5%. A cut-off of 5 points was identified as optimal to differentiate between pneumonitis and no pneumonitis. Moreover, pneumonitis was significantly associated with an increase of ≥3 points from baseline (<i>p</i> < 0.0001). The scoring system provided excellent accuracy and high patient satisfaction. Important foundations for the development of a mobile application were laid. |
| first_indexed | 2024-03-09T13:19:43Z |
| format | Article |
| id | doaj.art-b75c9934f55e474db9aba01b6d2d303d |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T13:19:43Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-b75c9934f55e474db9aba01b6d2d303d2023-11-30T21:32:17ZengMDPI AGCancers2072-66942023-01-0115232610.3390/cancers15020326Early Identification of Pneumonitis in Patients Irradiated for Lung Cancer—Final Results of the PARALUC TrialDirk Rades0Elisa M. Werner1Esther Glatzel2Sabine Bohnet3Steven E. Schild4Søren S. Tvilsted5Stefan Janssen6Department of Radiation Oncology, University of Lubeck, 23562 Lubeck, GermanyDepartment of Radiation Oncology, University of Lubeck, 23562 Lubeck, GermanyDepartment of Radiation Oncology, University of Lubeck, 23562 Lubeck, GermanyDepartment of Pulmonology, University of Lubeck, 23562 Lubeck, GermanyDepartment of Radiation Oncology, Mayo Clinic, Scottsdale, AZ 85259, USAResearch Department, Zealand University Hospital, 4600 Køge, DenmarkDepartment of Radiation Oncology, University of Lubeck, 23562 Lubeck, GermanyRadiotherapy of lung cancer may cause pneumonitis that generally occurs weeks or months following therapy and can be missed. This prospective trial aimed to pave the way for a mobile application (app) allowing early diagnosis of pneumonitis. The primary goal was the identification of the optimal cut-off of a score to detect pneumonitis of grade ≥2 after radiotherapy for lung cancer. Based on the severity of symptoms (cough, dyspnea, fever), scoring points were 0–9. Receiver operating characteristic (ROC)-curves were used to describe the sensitivity and specificity. The area under the ROC-curve (AUC) was calculated to judge the accuracy of the score, Youden-index was employed to define the optimal cut-off. Until trial termination, 57 of 98 patients were included. Eight of 42 patients evaluable for the primary endpoint (presence or absence of radiation pneumonitis) experienced pneumonitis. AUC was 0.987 (0.961–1.000). The highest sensitivity was achieved with 0–4 points (100%), followed by 5 points (87.5%), highest specificity with 5–6 points (100%). The highest Youden-index was found for 5 points (87.5%). The rate of patient satisfaction with the symptom-based scoring system was 93.5%. A cut-off of 5 points was identified as optimal to differentiate between pneumonitis and no pneumonitis. Moreover, pneumonitis was significantly associated with an increase of ≥3 points from baseline (<i>p</i> < 0.0001). The scoring system provided excellent accuracy and high patient satisfaction. Important foundations for the development of a mobile application were laid.https://www.mdpi.com/2072-6694/15/2/326lung cancerradiotherapypneumonitispatient reported outcomessymptom-based scoring systemmobile application |
| spellingShingle | Dirk Rades Elisa M. Werner Esther Glatzel Sabine Bohnet Steven E. Schild Søren S. Tvilsted Stefan Janssen Early Identification of Pneumonitis in Patients Irradiated for Lung Cancer—Final Results of the PARALUC Trial Cancers lung cancer radiotherapy pneumonitis patient reported outcomes symptom-based scoring system mobile application |
| title | Early Identification of Pneumonitis in Patients Irradiated for Lung Cancer—Final Results of the PARALUC Trial |
| title_full | Early Identification of Pneumonitis in Patients Irradiated for Lung Cancer—Final Results of the PARALUC Trial |
| title_fullStr | Early Identification of Pneumonitis in Patients Irradiated for Lung Cancer—Final Results of the PARALUC Trial |
| title_full_unstemmed | Early Identification of Pneumonitis in Patients Irradiated for Lung Cancer—Final Results of the PARALUC Trial |
| title_short | Early Identification of Pneumonitis in Patients Irradiated for Lung Cancer—Final Results of the PARALUC Trial |
| title_sort | early identification of pneumonitis in patients irradiated for lung cancer final results of the paraluc trial |
| topic | lung cancer radiotherapy pneumonitis patient reported outcomes symptom-based scoring system mobile application |
| url | https://www.mdpi.com/2072-6694/15/2/326 |
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