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Kraus, K.M. ; Bauer, C.* ; Feuerecker, B.* ; Fischer, J.C.* ; Borm, K.J.* ; Bernhardt, D.* ; Combs, S.E.

Pneumonitis after stereotactic thoracic radioimmunotherapy with checkpoint inhibitors: Exploration of the dose-volume-effect correlation.

Cancers 14:2948 (2022)
Verlagsversion DOI PMC
Open Access Gold
Creative Commons Lizenzvertrag
Thoracic stereotactic body radiation therapy (SBRT) is extensively used in combination with immune checkpoint blockade (ICB). While current evidence suggests that the occurrence of pneumonitis as a side effect of both treatments is not enhanced for the combination, the dose-volume correlation remains unclear. We investigate dose-volume-effect correlations for pneumonitis after combined SBRT + ICB. We analyzed patient clinical characteristics and dosimetric data for 42 data sets for thoracic SBRT with ICB treatment (13) and without (29). Dose volumes were converted into 2 Gy equivalent doses (EQD2), allowing for dosimetric comparison of different fractionation regimes. Pneumonitis volumes were delineated and corresponding DVHs were analyzed. We noticed a shift towards lower doses for combined SBRT + ICB treatment, supported by a trend of smaller areas under the curve (AUC) for SBRT+ ICB (median AUC 1337.37 vs. 5799.10, p = 0.317). We present a DVH-based dose-volume-effect correlation method and observed large pneumonitis volumes, even with bilateral extent in the SBRT + ICB group. We conclude that further studies using this method with enhanced statistical power are needed to clarify whether adjustments of the radiation dose constraints are required to better estimate risks of pneumonitis after the combination of SBRT and ICB.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Korrespondenzautor
Schlagwörter Checkpoint Inhibitors ; Lung Cancer ; Radioimmunotherapy (rit) ; Stereotactic Body Radiation Therapy (sbrt)
ISSN (print) / ISBN 2072-6694
Zeitschrift Cancers
Quellenangaben Band: 14, Heft: 12, Seiten: , Artikelnummer: 2948 Supplement: ,
Verlag MDPI
Nichtpatentliteratur Publikationen
Begutachtungsstatus Peer reviewed
Förderungen KMK and this research project was supported by grant by the German Cancer Consortium (DKTK). JCF was supported by the Else Kröner Forschungskolleg of the Technical University of MunichTUM.