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Pneumonitis after stereotactic thoracic radioimmunotherapy with checkpoint inhibitors: Exploration of the dose-volume-effect correlation.
Cancers 14:2948 (2022)
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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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
Checkpoint Inhibitors ; Lung Cancer ; Radioimmunotherapy (rit) ; Stereotactic Body Radiation Therapy (sbrt)
Language
english
Publication Year
2022
HGF-reported in Year
2022
ISSN (print) / ISBN
2072-6694
Journal
Cancers
Quellenangaben
Volume: 14,
Issue: 12,
Article Number: 2948
Publisher
MDPI
Reviewing status
Peer reviewed
Institute(s)
Institute of Radiation Medicine (IRM)
POF-Topic(s)
30203 - Molecular Targets and Therapies
Research field(s)
Radiation Sciences
PSP Element(s)
G-501300-001
Grants
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.
WOS ID
WOS:000816419100001
PubMed ID
35740613
Erfassungsdatum
2022-09-26