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Radiation pneumonitis in patients with non-small-cell lung cancer receiving chemoradiotherapy and an immune checkpoint inhibitor: a retrospective study
- Source :
- Radiation Oncology (London, England), Radiation Oncology, Vol 16, Iss 1, Pp 1-13 (2021)
- Publication Year :
- 2021
- Publisher :
- BioMed Central, 2021.
-
Abstract
- Background Immunotherapy has been administered to many patients with non-small-cell lung cancer (NSCLC). However, only few studies have examined toxicity in patients receiving an immune checkpoint inhibitor (ICI) after concurrent chemoradiotherapy (CCRT). Therefore, we performed a retrospective study to determine factors that predict radiation pneumonitis (RP) in these patients. Methods We evaluated the size of the planning target volume, mean lung dose (MLD), and the lung volume receiving more than a threshold radiation dose (VD) in 106 patients. The primary endpoint was RP ≥ grade 2, and toxicity was evaluated. Results After CCRT, 51/106 patients were treated with ICI. The median follow-up period was 11.5 months (range, 3.0–28.2), and RP ≥ grade 2 occurred in 47 (44.3%) patients: 27 and 20 in the ICI and non-ICI groups, respectively. Among the clinical factors, only the use of ICI was associated with RP (p = 0.043). Four dosimetric variables (MLD, V20, V30, and V40) had prognostic significance in univariate analysis for occurrence of pneumonitis (hazard ratio, p-value; MLD: 2.3, 0.009; V20: 2.9, 0.007; V30: 2.3, 0.004; V40: 2.5, 0.001). Only V20 was a significant risk factor in the non-ICI group, and MLD, V30, and V40 were significant risk factors in the ICI group. The survival and local control rates were superior in the ICI group than in the non-ICI group, but no significance was observed. Conclusions Patients receiving ICI after definitive CCRT were more likely to develop RP, which may be related to the lung volume receiving high-dose radiation. Therefore, several factors should be carefully considered for patients with NSCLC.
- Subjects :
- Oncology
Adult
Male
medicine.medical_specialty
Lung Neoplasms
Immune checkpoint inhibitors
R895-920
Medical physics. Medical radiology. Nuclear medicine
Internal medicine
Carcinoma, Non-Small-Cell Lung
medicine
Humans
In patient
Radiology, Nuclear Medicine and imaging
Lung cancer
Radiation Pneumonitis
Immune Checkpoint Inhibitors
RC254-282
Aged
Retrospective Studies
Aged, 80 and over
business.industry
Research
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Retrospective cohort study
Chemoradiotherapy
Middle Aged
medicine.disease
Prognosis
Concurrent chemoradiotherapy
Radiation therapy
Survival Rate
Tumor microenvironment
Dosimetric factor
Female
Non small cell
Immunotherapy
business
Non-small-cell lung cancer
Subjects
Details
- Language :
- English
- ISSN :
- 1748717X
- Volume :
- 16
- Database :
- OpenAIRE
- Journal :
- Radiation Oncology (London, England)
- Accession number :
- edsair.doi.dedup.....13826a5de1367385d997e2d3e6d34764