Wenxiao Jia1, Qianqian Gao2, Min Wang3, Ji Li3, Wang Jing3, Jinming Yu4,5, Hui Zhu6,7. 1. Department of Radiation Oncology, Shandong Cancer Hospital and Institute Affiliated to Shandong University, Shandong First Medical University, Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan, 250117, Shandong Province, China. 2. Department of Obstetrics and Gynecology, Qilu Hospital Affiliated to Shandong University, Jinan, 250012, Shandong Province, China. 3. Department of Radiation Oncology, Shandong Cancer Hospital and Institute Affiliated to Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, 250117, Shandong Province, China. 4. Department of Radiation Oncology, Shandong Cancer Hospital and Institute Affiliated to Shandong University, Shandong First Medical University, Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan, 250117, Shandong Province, China. sdyujinming@163.com. 5. Department of Radiation Oncology, Shandong Cancer Hospital and Institute Affiliated to Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, 250117, Shandong Province, China. sdyujinming@163.com. 6. Department of Radiation Oncology, Shandong Cancer Hospital and Institute Affiliated to Shandong University, Shandong First Medical University, Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan, 250117, Shandong Province, China. drzhuh@126.com. 7. Department of Radiation Oncology, Shandong Cancer Hospital and Institute Affiliated to Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, 250117, Shandong Province, China. drzhuh@126.com.
Abstract
BACKGROUND: The exact rate and relevant risk factors of radiation pneumonitis (RP) for non-small-cell cancer (NSCLC) patients treated with the combination of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) and thoracic radiotherapy have not been reported. Thus, this study aimed to investigate the rate and risk factors of RP for EGFR-positive NSCLC patients simultaneously treated with first-generation EGFR-TKI and TRT. PATIENTS AND METHODS: We retrospectively evaluated NSCLC patients simultaneously treated with first-generation EGFR-TKI and thoracic radiotherapy between January 2012 and December 2019 at Shandong Cancer Hospital and Institute, Shandong, China. RP was diagnosed via computed tomography and was classified according to the Common Terminology Criteria for Adverse Events v5.0. The risk factors of RP were identified using uni- and multivariate analyses. RESULTS: Of the 67 patients included, 44.78% (30/67) developed grade ≥ 2 RP. Grade ≥ 2 RP occurred within a median of 3.48 (range 1.07-13.6) months. The EGFR-TKI icotinib, ipsilateral lung V30 > 34%, and overlap time of > 20 days between EGFR-TKI and thoracic radiotherapy were identified to be independent predictive factors of grade ≥ 2 RP. CONCLUSIONS: Grade ≥ 2 RP is highly frequent in NSCLC patients simultaneous treated with first-generation EGFR-TKI and thoracic radiotherapy. Icotinib, ipsilateral lung V30 ≤ 34%, and overlap time of ≤ 20 days for EGFR-TKI and thoracic radiotherapy will be helpful to lower the risk of RP in these patients. The addition of thoracic radiotherapy should be cautious, and the treatment strategies can be optimized to reduce the rate of RP for patients treat with simultaneous EGFR-TKI and thoracic radiotherapy.
BACKGROUND: The exact rate and relevant risk factors of radiation pneumonitis (RP) for non-small-cell cancer (NSCLC) patients treated with the combination of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) and thoracic radiotherapy have not been reported. Thus, this study aimed to investigate the rate and risk factors of RP for EGFR-positive NSCLCpatients simultaneously treated with first-generation EGFR-TKI and TRT. PATIENTS AND METHODS: We retrospectively evaluated NSCLCpatients simultaneously treated with first-generation EGFR-TKI and thoracic radiotherapy between January 2012 and December 2019 at Shandong Cancer Hospital and Institute, Shandong, China. RP was diagnosed via computed tomography and was classified according to the Common Terminology Criteria for Adverse Events v5.0. The risk factors of RP were identified using uni- and multivariate analyses. RESULTS: Of the 67 patients included, 44.78% (30/67) developed grade ≥ 2 RP. Grade ≥ 2 RP occurred within a median of 3.48 (range 1.07-13.6) months. The EGFR-TKI icotinib, ipsilateral lung V30 > 34%, and overlap time of > 20 days between EGFR-TKI and thoracic radiotherapy were identified to be independent predictive factors of grade ≥ 2 RP. CONCLUSIONS: Grade ≥ 2 RP is highly frequent in NSCLCpatients simultaneous treated with first-generation EGFR-TKI and thoracic radiotherapy. Icotinib, ipsilateral lung V30 ≤ 34%, and overlap time of ≤ 20 days for EGFR-TKI and thoracic radiotherapy will be helpful to lower the risk of RP in these patients. The addition of thoracic radiotherapy should be cautious, and the treatment strategies can be optimized to reduce the rate of RP for patients treat with simultaneous EGFR-TKI and thoracic radiotherapy.
Authors: Prakash Chinnaiyan; Shyhmin Huang; Geetha Vallabhaneni; Eric Armstrong; Sooryanarayana Varambally; Scott A Tomlins; Arul M Chinnaiyan; Paul M Harari Journal: Cancer Res Date: 2005-04-15 Impact factor: 12.701
Authors: Malcolm Ranson; Lisa A Hammond; David Ferry; Mark Kris; Andrew Tullo; Philip I Murray; Vince Miller; Steve Averbuch; Judy Ochs; Charles Morris; Andrea Feyereislova; Helen Swaisland; Eric K Rowinsky Journal: J Clin Oncol Date: 2002-05-01 Impact factor: 44.544