Risk factors for radiation pneumonitis in NSCLC patients treated with third-generation EGFR TKIs and chest radiotherapy.

IF 3.3 2区医学 Q2 ONCOLOGY

Radiation Oncology Pub Date : 2025-05-09 DOI:10.1186/s13014-025-02649-0

Nan Zhao, Liang Xiong, Xuehong Bai, Wenyan Pan, Ping Hai, Hongqiang Ye, Ting Zhao, Kai Cui, Rong Ma, Yanyang Wang

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引用次数: 0

Abstract

Background: Non-small cell lung cancer (NSCLC) patients receiving third-generation EGFR TKIs with thoracic radiotherapy (TRT) significantly prolong survival and also increase the incidence of radiation pneumonitis (RP). The aim of our study was to investigate the incidence and risk factors of RP in NSCLC patients receiving third-generation EGFR TKIs and TRT.

Patients and methods: We retrospectively evaluated NSCLC patients who received both third-generation EGFR TKIs and TRT at the General Hospital of Ningxia Medical University from January 2023 to September 2024. RP was diagnosed by clinical symptoms on computed tomography (CT) scans and graded according to the Common Terminology Criteria for Adverse Events 5.0. Risk factors for RP were determined by univariate and multivariate logistic regression analysis.

Results: Of the 42 patients included, 26 (61.9%) developed RP and 14 (33.3%) developed grade ≥ 2 RP. Grade ≥ 2 RP all occurred within 6 months of receiving TRT, and the median time from TRT to RP was 3.69 months (2-10 months). GTV ≥ 39 ml and total lung V20 ≥ 14.95% were found to be independent risk factors for RP development.

Conclusion: The strategy of combining a third-generation TKI with TRT significantly increases the incidence of RP, and the risk of RP in these patients can be reduced by adjusting lung radiation dosimetry parameters. In NSCLC patients taking triple-generation TKIs with primary tumour progression, the timing and dose of TRT addition must be strictly controlled to optimise the therapeutic strategy and reduce the incidence of RP.

Clinical trial number: Not applicable.

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第三代EGFR TKIs和胸部放疗治疗非小细胞肺癌患者放射性肺炎的危险因素

背景：非小细胞肺癌（NSCLC）患者接受第三代EGFR TKIs联合胸部放疗（TRT）可显著延长生存期，同时也增加了放射性肺炎（RP）的发生率。本研究的目的是调查接受第三代EGFR TKIs和TRT治疗的NSCLC患者RP的发病率和危险因素。患者和方法：我们回顾性评估了2023年1月至2024年9月在宁夏医科大学总医院接受第三代EGFR TKIs和TRT治疗的非小细胞肺癌患者。RP通过计算机断层扫描（CT）的临床症状进行诊断，并根据不良事件通用术语标准5.0进行分级。通过单因素和多因素logistic回归分析确定RP的危险因素。结果：纳入的42例患者中，26例（61.9%）发展为RP， 14例（33.3%）发展为≥2级RP。≥2级RP均在接受TRT后6个月内发生，从TRT到RP的中位时间为3.69个月（2-10个月）。GTV≥39 ml和总肺V20≥14.95%是RP发生的独立危险因素。结论：第三代TKI联合TRT策略可显著增加RP的发生率，可通过调整肺辐射剂量学参数降低RP的发生风险。在原发性肿瘤进展的NSCLC患者中，必须严格控制TRT加药的时机和剂量，以优化治疗策略，降低RP的发生率。临床试验号：不适用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Radiation Oncology ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

6.50

自引率

2.80%

发文量

181

审稿时长

3-6 weeks

期刊介绍： Radiation Oncology encompasses all aspects of research that impacts on the treatment of cancer using radiation. It publishes findings in molecular and cellular radiation biology, radiation physics, radiation technology, and clinical oncology.