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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)
Publ. Version/Full Text 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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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Checkpoint Inhibitors ; Lung Cancer ; Radioimmunotherapy (rit) ; Stereotactic Body Radiation Therapy (sbrt)
ISSN (print) / ISBN 2072-6694
Journal Cancers
Quellenangaben Volume: 14, Issue: 12, Pages: , Article Number: 2948 Supplement: ,
Publisher MDPI
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Radiation Medicine (IRM)
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.