A comparison of the incidence of ≥ grade 2 radiation pneumonitis between intensity-modulated radiotherapy and three-dimensional conformal radiotherapy in patients with unresectable non-small cell lung cancer treated with durvalumab after concurrent chemoradiotherapy.

Autor:	Masuo M; Department of Respiratory Medicine, Tokyo Metropolitan Bokutoh Hospital, Tokyo 130-1022, Japan., Shinohara E; Department of Respiratory Medicine, Tokyo Metropolitan Bokutoh Hospital, Tokyo 130-1022, Japan., Kitano M; Department of Respiratory Medicine, Tokyo Metropolitan Bokutoh Hospital, Tokyo 130-1022, Japan., Maruta R; Department of Respiratory Medicine, Tokyo Metropolitan Bokutoh Hospital, Tokyo 130-1022, Japan., Chonabayashi S; Department of Respiratory Medicine, Tokyo Metropolitan Bokutoh Hospital, Tokyo 130-1022, Japan.; Department of Respiratory Medicine, Kashiwa City Hospital, Chiba 277-0825, Japan., Endo S; Department of Respiratory Medicine, Tokyo Metropolitan Bokutoh Hospital, Tokyo 130-1022, Japan.; Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo 113-8519, Japan., Matumoto S; Department of Respiratory Medicine, Tokyo Metropolitan Bokutoh Hospital, Tokyo 130-1022, Japan., Nishiyama N; Department of Respiratory Medicine, Tokyo Metropolitan Bokutoh Hospital, Tokyo 130-1022, Japan., Machitori Y; Department of Radiology, Tokyo Metropolitan Bokutoh Hospital, Tokyo 130-1022, Japan., Kobayashi M; Department of Respiratory Medicine, Tokyo Metropolitan Bokutoh Hospital, Tokyo 130-1022, Japan.
Jazyk:	angličtina
Zdroj:	Japanese journal of clinical oncology [Jpn J Clin Oncol] 2024 Mar 09; Vol. 54 (3), pp. 312-318.
DOI:	10.1093/jjco/hyad158
Abstrakt:	Background: Intensity-modulated radiation therapy (IMRT) has been increasingly used as a new radiation modality for unresectable non-small cell lung cancer (NSCLC). The risk factors for radiation pneumonitis (RP) during consolidation durvalumab following concurrent chemoradiotherapy (CCRT) using IMRT have not been thoroughly investigated. Methods: This retrospective study analyzed medical record data from consecutive patients diagnosed with NSCLC who underwent CCRT and consolidation durvalumab at our institution between April 2018 and September 2022. Since we adopted IMRT for the treatment of NSCLC in April 2020, these patients were categorized into two groups: those treated with IMRT after April 2020 and those treated with three-dimensional conformal radiotherapy (3D-CRT) before April 2020. Results: A total of 31 patients underwent IMRT (the IMRT group), while 25 patients underwent 3D-CRT (the 3D-CRT group). In both groups, the total dose was 60 Gy in 30 fractions. The cumulative incidence of ≥ grade 2 RP at 12 months was significantly lower in the IMRT group than in the 3D-CRT group (27.0% vs. 64.0%, hazard ratio [HR]: 0.338, 95% confidence interval [CI]: 0.144-0.793, p = 0.013). In the multivariable analysis, V20 (≥ 25.6%, HR: 2.706, 95% CI: 1.168-6.269, p = 0.020) and radiotherapy technique (IMRT, HR: 0.414, 95% CI: 0.172-0.994, p = 0.048) were identified as significant risk factors for ≥ grade 2 RP. Conclusions: IMRT is associated with a lower rate of ≥ grade 2 RP in patients with NSCLC who received CCRT followed by durvalumab. (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permission@oup.com.)
Databáze:	MEDLINE
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