Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan, 250117, Shandong, China.
Department of Intensive Care Unit, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan, 250117, Shandong, China.
J Transl Med. 2023 Jun 7;21(1):368. doi: 10.1186/s12967-023-04212-5.
As one of the common complications of radiotherapy, radiation pneumonia (RP) limits the prognosis of patients. Therefore, better identifying the high-risk factors that lead to RP is essential to effectively prevent its occurrence. However, as lung cancer treatment modalities are being replaced and the era of immunotherapy has arrived, literature that reviews the parameters and mode of radiotherapy, chemotherapy drugs, targeted drugs and current hot immune checkpoint inhibitors related to RP is lacking. This paper summarizes the risk factors for radiation pneumonia by retrieving and analysing previously published literature and the results of large clinical trials. The literature primarily included retrospective analyses, including clinical trials in different periods and a part of the literature review. A systematic literature search of Embase, PubMed, Web of Science, and Clinicaltrials.gov was performed for relevant publications up to 6 Dec. 2022. Search keywords include, but are not limited to, "radiation pneumonia", "pneumonia", "risk factors", "immunotherapy", etc. The factors related to RP in this paper include physical parameters of radiotherapy, including V, V, and MLD; chemoradiotherapy mode and chemotherapy drugs, including paclitaxel and gemcitabine; EGFR-TKI; ALK inhibitors; antiangiogenic drugs; immune drugs and the underlying disease of the patient. We also introduce the possible mechanism of RP. In the future, we hope that this article not only sounds the alarm for clinicians but also helps to identify a method that can effectively intervene and reduce the occurrence of RP, significantly improve the quality of life and prognosis of patients, and more effectively improve the therapeutic effect of radiation therapy.
作为放疗的常见并发症之一，放射性肺炎（RP）限制了患者的预后。因此，更好地识别导致 RP 的高危因素对于有效预防其发生至关重要。然而，随着肺癌治疗方式的改变和免疫治疗时代的到来，缺乏关于与 RP 相关的放射治疗参数和模式、化疗药物、靶向药物以及当前热门的免疫检查点抑制剂的文献综述。本文通过检索和分析以前发表的文献以及大型临床试验的结果，总结了放射性肺炎的危险因素。文献主要包括回顾性分析，包括不同时期的临床试验和一部分文献综述。对 Embase、PubMed、Web of Science 和 Clinicaltrials.gov 进行了系统的文献检索，以获取截至 2022 年 12 月 6 日的相关出版物。搜索关键词包括但不限于“放射性肺炎”、“肺炎”、“危险因素”、“免疫疗法”等。本文中与 RP 相关的因素包括放疗的物理参数，包括 V、V 和 MLD；放化疗模式和化疗药物，包括紫杉醇和吉西他滨；EGFR-TKI；ALK 抑制剂；抗血管生成药物；免疫药物和患者的基础疾病。我们还介绍了 RP 的可能机制。在未来，我们希望本文不仅能引起临床医生的警惕，还有助于确定一种能够有效干预和降低 RP 发生的方法，显著提高患者的生活质量和预后，并更有效地提高放疗的治疗效果。
