Article (Scientific journals)
Incidence, risk factors, and CT characteristics of radiation recall pneumonitis induced by immune checkpoint inhibitor in lung cancer.
COUSIN, François; DESIR, Colin; BEN MUSTAPHA, Selma et al.
2021In Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 157, p. 47-55
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Keywords :
Aged; Carcinoma, Non-Small-Cell Lung/drug therapy; Humans; Immune Checkpoint Inhibitors; Incidence; Lung Neoplasms/drug therapy; Male; Pneumonia; Radiation Pneumonitis/epidemiology/etiology; Retrospective Studies; Risk Factors; Tomography, X-Ray Computed; Anti PD-1/PD-L1; Lung cancer; Radiation pneumonitis; Radiation recall pneumonitis
Abstract :
[en] BACKGROUND AND PURPOSE: Radiation recall pneumonitis (RRP) is a delayed radiation-induced lung toxicity triggered by systemic agents, typically anticancer drugs. Immune checkpoint inhibitors (ICIs) have recently been identified as potential causal agents of RRP but its real incidence and potential risk factors remain unknown. MATERIALS AND METHODS: Medical records and CTs of patients treated with programmed death 1 (PD-1) or programmed death ligand 1 (PD-L1) inhibitors for advanced lung cancer between 2014 and 2019 at our tertiary center, and who had a previous history of lung irradiation were retrospectively analyzed. We identified RRP as lung CT modifications occurring in the irradiation field >6 months after conventionally fractionated radiotherapy completion and >1 year after stereotactic body radiation therapy. Clinical and dosimetric data were analyzed to identify potential risk factors for RRP. RESULTS: Among 348 patients treated with ICIs, data from 80 eligible patients were analyzed (median age, 69 years [interquartile range, 11]; 45 men). Fifteen patients (18.8%) presented with RRP. Median time between end of radiotherapy and RRP was 450 days (range, 231-1859). No risk factor was significantly associated with RRP. ICI-related pneumonitis was associated with RRP in 33.3% of cases (p = 0.0021), developing either concomitantly or after RRP. Incidence of grade ≥ 3 pneumonitis in the RRP population was 13.3 %. CONCLUSION: We demonstrated a high incidence of RRP (18.8%) in our population of previously irradiated patients treated with ICIs for lung cancer. We identified no risk factors for RRP, but an association was noted between RRP and ICI-related pneumonitis.
Disciplines :
Radiology, nuclear medicine & imaging
Author, co-author :
COUSIN, François  ;  Centre Hospitalier Universitaire de Liège - CHU > Département de Physique Médicale > Service médical de médecine nucléaire et imagerie onco
DESIR, Colin ;  Centre Hospitalier Universitaire de Liège - CHU > Département de Physique Médicale > Service médical de radiodiagnostic
BEN MUSTAPHA, Selma ;  Centre Hospitalier Universitaire de Liège - CHU > Département de Physique Médicale > Service médical de radiothérapie
MIEVIS, Carole ;  Centre Hospitalier Universitaire de Liège - CHU > Département de Physique Médicale > Service médical de radiothérapie
Coucke, Philippe  ;  Université de Liège - ULiège > Département des sciences cliniques > Radiothérapie
Hustinx, Roland  ;  Université de Liège - ULiège > Département des sciences cliniques > Médecine nucléaire
Language :
English
Title :
Incidence, risk factors, and CT characteristics of radiation recall pneumonitis induced by immune checkpoint inhibitor in lung cancer.
Publication date :
2021
Journal title :
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
ISSN :
0167-8140
eISSN :
1879-0887
Volume :
157
Pages :
47-55
Peer reviewed :
Peer reviewed
Commentary :
Copyright © 2021 Elsevier B.V. All rights reserved.
Available on ORBi :
since 05 June 2021

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