医学
放化疗
内科学
放射治疗
肺炎
杜瓦卢马布
肺癌
养生
外科
肺
癌症
免疫疗法
无容量
作者
Takashi Satō,Noriko Kishi,Yukinori Matsuo,Masakazu Ogura,Takamasa Mitsuyoshi,Norio Araki,Kimio Fujii,Shun Okumura,Kiyoshi Nakamatsu,Takahiro Kishi,Tomoko Atsuta,Takashi Sakamoto,Masaru Narabayashi,Yuichi Ishida,Masato Sakamoto,S. Fujishiro,Toshimasa Katagiri,Young Hak Kim
标识
DOI:10.1016/j.cllc.2021.01.017
摘要
Data on the risk factors for symptomatic radiation pneumonitis (RP) in non-small-cell lung cancer (NSCLC) patients treated with concurrent chemoradiotherapy (CCRT) and consolidation durvalumab are limited; we aimed to investigate these risk factors.This multicenter retrospective study, conducted at 15 institutions in Japan, included patients who were ≥20 years of age; who started definitive CCRT for NSCLC between July 1, 2018, and July 31, 2019; and who then received durvalumab. The primary endpoint was grade 2 or worse (grade 2+) RP.In the 146 patients analyzed, the median follow-up period was 16 months. A majority of the patients had stage III disease (86%), received radiation doses of 60 to 66 Gy equivalent in 2-Gy fractions (93%) and carboplatin and paclitaxel/nab-paclitaxel (77%), and underwent elective nodal irradiation (71%) and 3-dimensional conformal radiotherapy (75%). RP grade 2 was observed in 44 patients (30%); grade 3, in four patients (3%); grade 4, in one patient (1%); and grade 5, in one patient (1%). In the multivariable analysis, lung V20 was a significant risk factor, whereas age, sex, smoking history, irradiation technique, and chemotherapy regimen were not. The 12-month grade 2+ RP incidence was 34.4% (95% confidence interval [CI], 26.7%-42.1%); the values were 50.0% (95% CI, 34.7%-63.5%) and 27.1% (95% CI, 18.8%-36.2%) in those with lung V20 ≥ 26% and < 26%, respectively (P = .007).The incidence of grade 2+ RP was relatively high in this multicenter real-world study, and its risk increased remarkably at elevated lung V20. Our findings can aid in RP risk prediction and the safe radiotherapy treatment planning.
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