Abstract：
OBJECTIVE: To evaluate the association between prophylactic administration of clarithromycin (CAM) and the development of radiation pneumonitis (RP) in patients treated with intensity modulated radiation therapy (IMRT) for lung cancer.
METHODS: A total of 89 patients who underwent definitive or salvage IMRT for lung cancer were retrospectively evaluated. The median total and daily doses were 60 Gy and 2 Gy, respectively. A total of 39 patients (44%) received CAM for a median of three months after the start of IMRT. The relationship between the development of RP and certain clinical factors was analyzed.
RESULTS: RP of Grade ≥2 was recognized in 10 (11%) patients; Grade 2 in six patients and Grade 3 in four patients. The incidence of Grade ≥2 RP was 3% (1/39) in patients treated with CAM, which was significantly lower than that of 18% (9/50) in patients without CAM. The median lung V20 and V5 in the 10 patients with RP Grade ≥2 were 24% and 46%, respectively, compared with 18% and 37% in the 79 patients with RP Grade 0-1, and the differences were significant. Durvalumab administration after IMRT was also a significant factor for RP Grade ≥2.
CONCLUSIONS: Prophylactic administration of CAM may reduce Grade ≥2 RP in patients treated with IMRT for lung cancer. Therefore, further clinical trials are warranted.
METHODS: A total of 89 patients who underwent definitive or salvage IMRT for lung cancer were retrospectively evaluated. The median total and daily doses were 60 Gy and 2 Gy, respectively. A total of 39 patients (44%) received CAM for a median of three months after the start of IMRT. The relationship between the development of RP and certain clinical factors was analyzed.
RESULTS: RP of Grade ≥2 was recognized in 10 (11%) patients; Grade 2 in six patients and Grade 3 in four patients. The incidence of Grade ≥2 RP was 3% (1/39) in patients treated with CAM, which was significantly lower than that of 18% (9/50) in patients without CAM. The median lung V20 and V5 in the 10 patients with RP Grade ≥2 were 24% and 46%, respectively, compared with 18% and 37% in the 79 patients with RP Grade 0-1, and the differences were significant. Durvalumab administration after IMRT was also a significant factor for RP Grade ≥2.
CONCLUSIONS: Prophylactic administration of CAM may reduce Grade ≥2 RP in patients treated with IMRT for lung cancer. Therefore, further clinical trials are warranted.
摘要：
目的：评价肺癌调强放疗(IMRT)患者预防性使用克拉霉素(CAM)与放射性肺炎(RP)发生的关系。
方法：对89例接受确定性或挽救性肺癌IMRT的患者进行回顾性评估。中位总剂量和每日剂量分别为60Gy和2Gy，分别。在IMRT开始后，共有39名患者（44％）接受了CAM，中位时间为三个月。分析RP的发生发展与某些临床因素的关系。
结果：在10例（11％）患者中发现了≥2级的RP；6例患者为2级，4例患者为3级。在接受CAM治疗的患者中，≥2级RP的发生率为3％（1/39），显著低于无CAM患者的18%(9/50)。10例RP≥2级患者的肺V20和V5中位数分别为24%和46%,分别,与79例RP0-1级患者的18％和37％相比，差异有统计学意义。IMRT后Durvalumab给药也是RP等级≥2的重要因素。
结论：在接受IMRT治疗的肺癌患者中，预防性给予CAM可降低≥2级RP。因此,需要进一步的临床试验.
方法：对89例接受确定性或挽救性肺癌IMRT的患者进行回顾性评估。中位总剂量和每日剂量分别为60Gy和2Gy，分别。在IMRT开始后，共有39名患者（44％）接受了CAM，中位时间为三个月。分析RP的发生发展与某些临床因素的关系。
结果：在10例（11％）患者中发现了≥2级的RP；6例患者为2级，4例患者为3级。在接受CAM治疗的患者中，≥2级RP的发生率为3％（1/39），显著低于无CAM患者的18%(9/50)。10例RP≥2级患者的肺V20和V5中位数分别为24%和46%,分别,与79例RP0-1级患者的18％和37％相比，差异有统计学意义。IMRT后Durvalumab给药也是RP等级≥2的重要因素。
结论：在接受IMRT治疗的肺癌患者中，预防性给予CAM可降低≥2级RP。因此,需要进一步的临床试验.
