Incidence and dose-volume relationship of radiation pneumonitis after concurrent chemoradiotherapy followed by durvalumab for locally advanced non-small cell lung cancer

Satoshi Saito; Takanori Abe; Nao Kobayashi; Tomomi Aoshika; Yasuhiro Ryuno; Mitsunobu Igari; Ryuta Hirai; Yu Kumazaki; Yu Miura; Kyoichi Kaira; Hiroshi Kagamu; Shin-Ei Noda; Shingo Kato

doi:10.1016/j.ctro.2020.05.006

Incidence and dose-volume relationship of radiation pneumonitis after concurrent chemoradiotherapy followed by durvalumab for locally advanced non-small cell lung cancer

Clin Transl Radiat Oncol. 2020 May 30:23:85-88. doi: 10.1016/j.ctro.2020.05.006. eCollection 2020 Jul.

Authors

Affiliations

¹ Department of Radiation Oncology, International Medical Center, Saitama Medical University, Hidaka, Japan.
² Department of Respiratory Medicine, International Medical Center, Saitama Medical University, Hidaka, Japan.

Abstract

Background and purpose: We investigated the incidence and dose-volume relationships of radiation pneumonitis (RP) after concurrent chemoradiotherapy (CCRT) followed by durvalumab for locally advanced non-small-cell lung cancer (LA-NSCLC).

Materials and methods: We retrospectively analyzed records of 36 patients with LA-NSCLC who underwent CCRT followed by durvalumab. Incidence of RP was analyzed for correlations with clinical factors and dose-volume parameters of lung in radiotherapy.

Results: All patients received 60 Gy in 30 fractions of radiotherapy with concurrent chemotherapy. Over a median follow-up period of 7 months, incidence of grade ≥2 RP was 36% (including grade 3 RP: 5% and grade 5 RP: 3%). Age, sex, Brinkman index, and blood test results did not significantly differ between patients with grade ≥2 RP and grade ≤1 RP. Dose-volume parameters (lung volumes that received 5 Gy, 10 Gy, 20 Gy, 30 Gy, 40 Gy, 50 Gy, and mean lung dose) were significantly higher among patients with grade ≥2 RP compared with patients with grade ≤1 RP.

Conclusion: Incidence of grade ≥2 RP was 36% after CCRT followed by durvalumab for LA-NSCLC, but did not significantly differ from those of patients treated with CCRT alone. Lung dose-volume parameters were significantly correlated with RP.

Keywords: Dose-volume parameters; Durvalumab; Lung cancer; Radiation pneumonitis.