Radiation pneumonitis in patients with non-small-cell lung cancer receiving chemoradiotherapy and an immune checkpoint inhibitor: a retrospective study

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 retrospec...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Jeong Yun Jang, Su Ssan Kim, Si Yeol Song, Yeon Joo Kim, Sung-woo Kim, Eun Kyung Choi
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Non-small-cell lung cancer Concurrent chemoradiotherapy Radiation therapy Immunotherapy Dosimetric factor Tumor microenvironment Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/733581fe7b7140b29f334aa68bcd9aaf
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:733581fe7b7140b29f334aa68bcd9aaf
record_format	dspace
spelling	oai:doaj.org-article:733581fe7b7140b29f334aa68bcd9aaf2021-12-05T12:10:23ZRadiation pneumonitis in patients with non-small-cell lung cancer receiving chemoradiotherapy and an immune checkpoint inhibitor: a retrospective study10.1186/s13014-021-01930-21748-717Xhttps://doaj.org/article/733581fe7b7140b29f334aa68bcd9aaf2021-12-01T00:00:00Zhttps://doi.org/10.1186/s13014-021-01930-2https://doaj.org/toc/1748-717XAbstract 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.Jeong Yun JangSu Ssan KimSi Yeol SongYeon Joo KimSung-woo KimEun Kyung ChoiBMCarticleNon-small-cell lung cancerConcurrent chemoradiotherapyRadiation therapyImmunotherapyDosimetric factorTumor microenvironmentMedical physics. Medical radiology. Nuclear medicineR895-920Neoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENRadiation Oncology, Vol 16, Iss 1, Pp 1-13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Non-small-cell lung cancer Concurrent chemoradiotherapy Radiation therapy Immunotherapy Dosimetric factor Tumor microenvironment Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Non-small-cell lung cancer Concurrent chemoradiotherapy Radiation therapy Immunotherapy Dosimetric factor Tumor microenvironment Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Jeong Yun Jang Su Ssan Kim Si Yeol Song Yeon Joo Kim Sung-woo Kim Eun Kyung Choi Radiation pneumonitis in patients with non-small-cell lung cancer receiving chemoradiotherapy and an immune checkpoint inhibitor: a retrospective study
description	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.
format	article
author	Jeong Yun Jang Su Ssan Kim Si Yeol Song Yeon Joo Kim Sung-woo Kim Eun Kyung Choi
author_facet	Jeong Yun Jang Su Ssan Kim Si Yeol Song Yeon Joo Kim Sung-woo Kim Eun Kyung Choi
author_sort	Jeong Yun Jang
title	Radiation pneumonitis in patients with non-small-cell lung cancer receiving chemoradiotherapy and an immune checkpoint inhibitor: a retrospective study
title_short	Radiation pneumonitis in patients with non-small-cell lung cancer receiving chemoradiotherapy and an immune checkpoint inhibitor: a retrospective study
title_full	Radiation pneumonitis in patients with non-small-cell lung cancer receiving chemoradiotherapy and an immune checkpoint inhibitor: a retrospective study
title_fullStr	Radiation pneumonitis in patients with non-small-cell lung cancer receiving chemoradiotherapy and an immune checkpoint inhibitor: a retrospective study
title_full_unstemmed	Radiation pneumonitis in patients with non-small-cell lung cancer receiving chemoradiotherapy and an immune checkpoint inhibitor: a retrospective study
title_sort	radiation pneumonitis in patients with non-small-cell lung cancer receiving chemoradiotherapy and an immune checkpoint inhibitor: a retrospective study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/733581fe7b7140b29f334aa68bcd9aaf
work_keys_str_mv	AT jeongyunjang radiationpneumonitisinpatientswithnonsmallcelllungcancerreceivingchemoradiotherapyandanimmunecheckpointinhibitoraretrospectivestudy AT sussankim radiationpneumonitisinpatientswithnonsmallcelllungcancerreceivingchemoradiotherapyandanimmunecheckpointinhibitoraretrospectivestudy AT siyeolsong radiationpneumonitisinpatientswithnonsmallcelllungcancerreceivingchemoradiotherapyandanimmunecheckpointinhibitoraretrospectivestudy AT yeonjookim radiationpneumonitisinpatientswithnonsmallcelllungcancerreceivingchemoradiotherapyandanimmunecheckpointinhibitoraretrospectivestudy AT sungwookim radiationpneumonitisinpatientswithnonsmallcelllungcancerreceivingchemoradiotherapyandanimmunecheckpointinhibitoraretrospectivestudy AT eunkyungchoi radiationpneumonitisinpatientswithnonsmallcelllungcancerreceivingchemoradiotherapyandanimmunecheckpointinhibitoraretrospectivestudy
_version_	1718372199651344384

Radiation pneumonitis in patients with non-small-cell lung cancer receiving chemoradiotherapy and an immune checkpoint inhibitor: a retrospective study

Ejemplares similares