ArticleCancer medicine2021
Safety of thoracic radiotherapy after PD-(L)1 inhibitor treatment in patients with lung cancer.
Article in Cancer medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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12 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.
- Incidences of pneumonitis associated with the combination of radiotherapy and immune checkpoint inhibitors in lung cancer: a systematic review and meta-analysis.Frontiers in oncology · 2025Pooled it
- Comparing the Prognosis of Non-Small Cell Lung Cancer Patients Who Did Not Undergo Surgery After Neoadjuvant Chemotherapy Combined With Immunotherapy: A Retrospective Study.Thoracic cancer · 2026Article
- Consolidative thoracic radiotherapy following first-line chemo-immunotherapy in extensive-stage small-cell lung cancer: A systematic review and meta-analysis.Therapeutic advances in medical oncology · 2026Article
- Radiation-induced lung injury in the era of combination anticancer therapy: a narrative review.Frontiers in immunology · 2026Review
- Expert consensus on cancer treatment-related lung injury.Journal of thoracic disease · 2025Review
- A Systematic Review of Pneumonitis Following Treatment with Immune Checkpoint Inhibitors and Radiotherapy.Biomedicines · 2025Review
- Timing of thoracic radiotherapy combined with immunotherapy influences pulmonary injury.Oncology letters · 2025Article
- Clinical characteristics and biomarkers of severe immune checkpoint inhibitor-related pneumonitis triggered by immunotherapy followed by radiation: a case report.Frontiers in immunology · 2024Article
- Multimodal data deep learning method for predicting symptomatic pneumonitis caused by lung cancer radiotherapy combined with immunotherapy.Frontiers in immunology · 2024Article
- Real-world outcomes of PD-L1 inhibitors combined with thoracic radiotherapy in the first-line treatment of extensive stage small cell lung cancer.Radiation oncology (London, England) · 2023Article
- Case report: Pneumonia with clinical symptoms precedes imaging evidence after immune checkpoint inhibitors combined with radiotherapy in lung squamous cell cancer.Frontiers in immunology · 2022Article
- Safety of thoracic radiotherapy after PD-(L)1 inhibitor treatment in patients with lung cancer.Cancer medicine · 2021Article
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe safety of thoracic radiotherapy (TRT) after programmed death 1/programmed death ligand 1 (PD-(L)1) inhibitor treatment in patients with lung cancer was scarcely reported. This retrospective study was conducted to evaluate the incidence, severity, and risk factors of symptomatic treatment-related pneumonitis in patients with lung cancer who received this sequential combination.
methodsWe conducted a retrospective study of a cohort of patients with lung cancer who received TRT after at least two cycles of PD-(L)1 inhibitor treatment between January 2018 and August 2020. Treatment-related pneumonitis was evaluated and analyzed to illustrate the safety profile of this sequential combination. Potential risk factors were explored by univariate and multivariate logistic regression analyses.
resultsAmong the 828 patients with prior PD-(L)1 inhibitor treatment, 96 patients receiving subsequent TRT were included in the analysis. Of these, 49 patients (51%) received radical TRT while 47 patients (49%) received palliative TRT. The median total dose was 52 Gy (IQR 50-60 Gy). The median time from the initiation of PD-(L)1 inhibitor treatment to TRT was 4.8 months (1.6-14.1 months) with most of the patients (74%) administering no less than four cycles of PD-(L)1 inhibitor. During follow-up, 47 patients (48.96%) developed symptomatic treatment-related pneumonitis (grade 2 n = 28, grade ≥3 n = 19) while six patients (6.25%) suffered from fatal toxicity. The median time of pneumonitis onset after completion of TRT was 35 days (0-177 days) with six patients developing during TRT. Pulmonary emphysema and lung V20 were demonstrated to be independent risk factors of symptomatic pneumonitis (OR: 5.67, 95% CI: 1.66-19.37, p = 0.006; OR: 3.49, 95% CI: 1.41-8.66, p = 0.007, respectively).
conclusionTRT after PD-(L)1 inhibitor treatment resulted in significantly increased incidence and severity of treatment-related pneumonitis in patients with lung cancer. Intensive attention should be emphasized to the safety of this sequential combination in clinical practice.
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