Department of Radiotherapy, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
Division of Cancer, Department of Surgery and Cancer, Imperial College London, London, UK.
BMC Pulm Med. 2022 Feb 5;22(1):54. doi: 10.1186/s12890-022-01846-x.
Radiation recall pneumonitis (RRP) is unpredictable but associated with severe radiation damage in previously irradiated fields. Chemotherapy and targeted drugs have been reported to contribute to RRP. Here we report a case of a patient with non-small cell lung cancer (NSCLC) who developed RRP following administration of immune checkpoint inhibitor (ICI) 18 months after the end of re-irradiation.
A 69-year-old man received adjuvant chemoradiotherapy post-operatively. He underwent thoracic re-irradiation for oligometastatic NSCLC. On second recurrence, pembrolizumab combined with nab-paclitaxel were administered. After six months, he developed symptoms of persistent cough and dyspnea, with consistent pneumonitis on CT images. The clinical time frame and significant radiographic evidence raised suspicion for RRP. Symptoms resolved after steroids.
RRP is a rare occurrence. Patients undergoing immunotherapy after prior irradiation may be at increased risk of this rare radiation pneumonitis.
放射性回忆性肺炎（RRP）不可预测，但与先前照射野的严重放射性损伤有关。据报道，化疗和靶向药物可导致 RRP。在这里，我们报告了一例非小细胞肺癌（NSCLC）患者的病例，该患者在接受再放疗 18 个月后接受免疫检查点抑制剂（ICI）治疗后发生了 RRP。
一名 69 岁男性在术后接受了辅助化疗和放疗。他因寡转移性 NSCLC 接受了胸部再放疗。第二次复发时，给予了帕博利珠单抗联合nab-紫杉醇治疗。六个月后，他出现持续性咳嗽和呼吸困难的症状，CT 图像上持续存在肺炎。临床时间框架和明显的影像学证据提示存在 RRP 的可能性。使用类固醇后症状缓解。
RRP 是一种罕见的疾病。在先前接受过放疗的患者中进行免疫治疗可能会增加发生这种罕见放射性肺炎的风险。
