PDF(Pubmed)
Abstract：
UNASSIGNED: Thoracic radiotherapy (TRT) is increasingly used in patients receiving osimertinib for advanced NSCLC, and the risk of pneumonitis is not established. We investigated the risk of pneumonitis and potential risk factors in this population.
UNASSIGNED: We performed a multi-institutional retrospective analysis of patients under active treatment with osimertinib who received TRT between April 2016 and July 2022 at two institutions. Clinical characteristics, including whether osimertinib was held during TRT and pneumonitis incidence and grade (Common Terminology Criteria for Adverse Events version 5.0) were documented. Logistic regression analysis was performed to identify risk factors associated with grade 2 or higher (2+) pneumonitis.
UNASSIGNED: The median follow-up was 10.2 months (range: 1.9-53.2). Of 102 patients, 14 (13.7%) developed grade 2+ pneumonitis, with a median time to pneumonitis of 3.2 months (range: 1.5-6.3). Pneumonitis risk was not significantly increased in patients who continued osimertinib during TRT compared with patients who held osimertinib during TRT (9.1% versus 15.0%, p = 0.729). Three patients (2.9%) had grade 3 pneumonitis, none had grade 4, and two patients had grade 5 events (2.0%, diagnosed 3.2 mo and 4.4 mo post-TRT). Mean lung dose was associated with the development of grade 2+ pneumonitis in multivariate analysis (OR = 1.19, p = 0.021).
UNASSIGNED: Although the overall rate of pneumonitis in patients receiving TRT and osimertinib was relatively low, there was a small risk of severe toxicity. The mean lung dose was associated with an increased risk of developing pneumonitis. These findings inform decision-making for patients and providers.
UNASSIGNED: We performed a multi-institutional retrospective analysis of patients under active treatment with osimertinib who received TRT between April 2016 and July 2022 at two institutions. Clinical characteristics, including whether osimertinib was held during TRT and pneumonitis incidence and grade (Common Terminology Criteria for Adverse Events version 5.0) were documented. Logistic regression analysis was performed to identify risk factors associated with grade 2 or higher (2+) pneumonitis.
UNASSIGNED: The median follow-up was 10.2 months (range: 1.9-53.2). Of 102 patients, 14 (13.7%) developed grade 2+ pneumonitis, with a median time to pneumonitis of 3.2 months (range: 1.5-6.3). Pneumonitis risk was not significantly increased in patients who continued osimertinib during TRT compared with patients who held osimertinib during TRT (9.1% versus 15.0%, p = 0.729). Three patients (2.9%) had grade 3 pneumonitis, none had grade 4, and two patients had grade 5 events (2.0%, diagnosed 3.2 mo and 4.4 mo post-TRT). Mean lung dose was associated with the development of grade 2+ pneumonitis in multivariate analysis (OR = 1.19, p = 0.021).
UNASSIGNED: Although the overall rate of pneumonitis in patients receiving TRT and osimertinib was relatively low, there was a small risk of severe toxicity. The mean lung dose was associated with an increased risk of developing pneumonitis. These findings inform decision-making for patients and providers.
摘要：
■胸部放疗（TRT）越来越多地用于接受奥希替尼治疗晚期非小细胞肺癌的患者，肺炎的风险尚未确定。我们调查了该人群的肺炎风险和潜在危险因素。
我们对2016年4月至2022年7月在两个机构接受奥希替尼积极治疗的患者进行了多机构回顾性分析。临床特征,包括在TRT期间是否服用奥希替尼,并记录肺炎的发生率和分级(不良事件通用术语标准5.0版).进行Logistic回归分析以确定与2级或更高（2+）肺炎相关的危险因素。
■中位随访时间为10.2个月（范围：1.9-53.2）。102名患者中,14人(13.7%)出现2级以上肺炎,肺炎的中位时间为3.2个月（范围：1.5-6.3）。与在TRT期间服用奥希替尼的患者相比，在TRT期间继续服用奥希替尼的患者肺炎风险没有显著增加（9.1%vs15.0%，p=0.729）。3例(2.9%)有3级肺炎,无4级，2例患者发生5级事件（2.0%，诊断为3.2个月，TRT后4.4个月）。在多变量分析中，平均肺剂量与2级肺炎的发展相关（OR=1.19，p=0.021）。
■尽管接受TRT和奥希替尼的患者的肺炎总发生率相对较低，严重毒性的风险很小.平均肺剂量与发生肺炎的风险增加有关。这些发现为患者和提供者的决策提供了依据。
我们对2016年4月至2022年7月在两个机构接受奥希替尼积极治疗的患者进行了多机构回顾性分析。临床特征,包括在TRT期间是否服用奥希替尼,并记录肺炎的发生率和分级(不良事件通用术语标准5.0版).进行Logistic回归分析以确定与2级或更高（2+）肺炎相关的危险因素。
■中位随访时间为10.2个月（范围：1.9-53.2）。102名患者中,14人(13.7%)出现2级以上肺炎,肺炎的中位时间为3.2个月（范围：1.5-6.3）。与在TRT期间服用奥希替尼的患者相比，在TRT期间继续服用奥希替尼的患者肺炎风险没有显著增加（9.1%vs15.0%，p=0.729）。3例(2.9%)有3级肺炎,无4级，2例患者发生5级事件（2.0%，诊断为3.2个月，TRT后4.4个月）。在多变量分析中，平均肺剂量与2级肺炎的发展相关（OR=1.19，p=0.021）。
■尽管接受TRT和奥希替尼的患者的肺炎总发生率相对较低，严重毒性的风险很小.平均肺剂量与发生肺炎的风险增加有关。这些发现为患者和提供者的决策提供了依据。
