Post Radiation Pneumonitis in Lung Cancer Patients with Interstitial Lung Disease

Post Radiation Pneumonitis in Lung Cancer Patients with Interstitial Lung Disease

shutterstock_188967473A recently-concluded study from Kyoto University suggests patients diagnosed with Stage I non-small cell lung cancer (NSCLC) who have been treated with stereotactic body radiation therapy (SBRT) may have an increased risk of developing severe radiation pneumonitis if they have interstitial lung disease (ILD) prior to radiotherapy.

ILD is known to cause scarring and hardening of the structures around the lung alveoli, which leads to inefficient gas exchange. ILD is more common in lung cancer patients, and unfortunately does not bode well for a surgical intervention. While SBRT is a good option for NSCLC patients who cannot undergo surgery, severe post-radiotherapy pneumonitis may be a consequence.

The researchers, sought to determine the best treatment option for NSCLC patients with ILD. They counted incidences of radiation pneumonitis in 157 patients who had undergone SBRT, and found 20 individuals had ILD and subsequent pneumonitis. While they also observed a shorter survival in those with ILD, it did not make a significant statistical difference and could be attributed solely to the presence of ILD. There were also no significant differences in disease progression.

“Our results suggest that the impact of ILD on radiation pneumonitis depends on the preexisting severity of the ILD findings and clinicians should be cautious when considering SBRT for those with significant ILD findings. However, other than radiation pneumonitis, life-threatening complications after SBRT are rare. Thus, if the severity of ILD and the risk of radiation pneumonitis are carefully evaluated, SBRT is a curative-intent treatment option for those with early-stage NSCLC and pretreatment ILD”, the authors state in their study.

The findings were published in the latest issue of the Journal of Thoracic Oncology, the official journal of the International Association for the Study of Lung Cancer (IASLC), where the study’s co-author and senior author, Yukinori Matsuo and Masahiro Hiraoka, are active members.

In other news on available treatments for lung cancer, the US Food and Drug Administration granted Merck’s Keytruda (pembrolizumab) Breakthrough Therapy Designation for the treatment of patients with non-small cell lung cancer (NSCLC) that has progressed on or following platinum-based chemotherapy.

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