Cancer Management and Research (Aug 2022)
Research Progress on Radiotherapy Combined with Immunotherapy for Associated Pneumonitis During Treatment of Non-Small Cell Lung Cancer
Abstract
Anqi Zhang,1,* Fuyuan Yang,2,* Lei Gao,1,* Xiaoyan Shi,3 Jiyuan Yang1 1Department of Oncology, First Affiliated Hospital of Yangtze University, Jingzhou, People’s Republic of China; 2School of Basic Medicine, Health Science Center, Yangtze University, Jingzhou, People’s Republic of China; 3Department of Gynaecology and Obstetrics, First Affiliated Hospital of Yangtze University, Jingzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jiyuan Yang, Department of Oncology, First Affiliated Hospital of Yangtze University, Jingzhou, People’s Republic of China, Tel +86 189 7216 1658, Fax +86 716-8062633, Email [email protected]: Radiation pneumonitis is a common and serious complication of radiotherapy for thoracic tumours. Although radiotherapy technology is constantly improving, the incidence of radiation pneumonitis is still not low, and severe cases can be life-threatening. Once radiation pneumonitis develops into radiation fibrosis (RF), it will have irreversible consequences, so it is particularly important to prevent the occurrence and development of radiation pneumonitis. Immune checkpoint inhibitors (ICIs) have rapidly altered the treatment landscape for multiple tumour types, providing unprecedented survival in some patients, especially for the treatment of non-small cell lung cancer (NSCLC). However, in addition to its remarkable curative effect, ICls may cause immune-related adverse events. The incidence of checkpoint inhibitor pneumonitis (CIP) is 3% to 5%, and its mortality rate is 10% to 17%. In addition, the incidence of CIP in NSCLC is higher than in other tumour types, reaching 7%– 13%. With the increasing use of immune checkpoint inhibitors (ICls) and thoracic radiotherapy in the treatment of patients with NSCLC, ICIs may induce delayed radiation pneumonitis in patients previously treated with radiation therapy, or radiation activation of the systemic immune system increases the toxicity of adverse reactions, which may lead to increased pulmonary toxicity and the incidence of pneumonitis. In this paper, the data about the occurrence of radiation pneumonitis, immune pneumonitis, and combined treatment and the latest related research results will be reviewed.Keywords: radiation pneumonitis, immune pneumonitis, pneumonitis after combination therapy, treatment and management of pneumonitis
