Optimal dose-volume histogram thresholds for radiation pneumonitis prevention in lung cancer patients receiving immunotherapy.

Yechen Ma, Ziyang Feng, Hao Zhou, Xuewen Liu, Zewen Song

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Article in Radiation oncology (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1 citing paper in PubMed.

Single-arm, multicentre phase II trial of sintilimab plus platinum-based doublet chemotherapy followed by adaptive radiotherapy strategy for patients with unresectable stage III non-small-cell lung cancer in China: the ART-LUNG 01 study protocol.BMJ open · 2026
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5 authors.

Yechen Ma *Department of Oncology, The Third Xiangya Hospital of Central South University, Changsha, China.

Ziyang Feng *Department of Oncology, The Third Xiangya Hospital of Central South University, Changsha, China.

Hao ZhouDepartment of Oncology, Xiangxi Autonomous Prefecture People's Hospital, Jishou, China.

Xuewen LiuDepartment of Oncology, The Third Xiangya Hospital of Central South University, Changsha, China. aveinliu@csu.edu.cn.

Zewen SongDepartment of Oncology, The Third Xiangya Hospital of Central South University, Changsha, China. xy3songzw@csu.edu.cn.

Funding

the Excellent Talent Cultivation Program of the Third Xiangya Hospital YX202211the National Natural Science Foundation of China 82373049

6 · The paper itself

Abstract

objectivesTo evaluate the incidence of symptomatic radiation pneumonitis (RP) in lung cancer patients receiving immunotherapy and radiotherapy. MATERIALS AND

methodsWe retrospectively analyzed 389 lung cancer patients who underwent thoracic radiotherapy with/without immunotherapy at the Third Xiangya Hospital (January 2015-September 2024). Propensity score matching (PSM) was employed to compare RP incidence. Univariate, multivariate, and stepwise regression analyses were conducted to identify predictors of grade ≥ 2 RP.

resultsSymptomatic RP occurred in 30.33% (118/389) and 7.46% (29/389) of patients for grades ≥ 2 and ≥ 3, respectively. Patients receiving concurrent immunotherapy-radiotherapy demonstrated a significantly lower incidence of grade ≥ 2 RP compared to other treatment groups (p < 0.05). Multivariable analysis revealed no significant association between immunotherapy administration and RP risk. Lung V20 (≤ 20% vs. > 20%) emerged as a critical predictor: grade ≥ 2 RP incidence was 4.05-8.73% with V20 ≤ 20%, versus 53.8-65.5% when V20 exceeded 20%.

conclusionsImmunotherapy did not raise the risk of grade ≥ 2 RP. Maintaining lung V20 ≤ 20% may serve as an optimal dosimetric threshold for RP prevention in patients undergoing combined-modality therapy. CLINICAL TRIAL NUMBER: Not applicable.

Indexed as

ImmunotherapyLung NeoplasmsRadiation PneumonitisAdultAgedAged, 80 and overFemaleHumansIncidenceMaleMiddle AgedRadiotherapy DosageRetrospective StudiesImmunotherapyLung cancerRadiation pneumonitisRadiotherapy

Identifiers

PMID40264199

DOI10.1186/s13014-025-02639-2

PMCPMC12016329

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LicenceCC BY-NC-ND

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