Zhao Nan, Xiong Liang, Bai Xuehong, Pan Wenyan, Hai Ping, Ye Hongqiang, Zhao Ting, Cui Kai, Ma Rong, Wang Yanyang
Master Training Station, General Hospital of Ningxia Medical University, Yinchuan, China.
Graduate School of Ningxia Medical University, Yinchuan, China.
Radiat Oncol. 2025 May 9;20(1):72. doi: 10.1186/s13014-025-02649-0.
Non-small cell lung cancer (NSCLC) patients receiving third-generation EGFR TKIs with thoracic radiotherapy (TRT) significantly prolong survival and also increase the incidence of radiation pneumonitis (RP). The aim of our study was to investigate the incidence and risk factors of RP in NSCLC patients receiving third-generation EGFR TKIs and TRT.
We retrospectively evaluated NSCLC patients who received both third-generation EGFR TKIs and TRT at the General Hospital of Ningxia Medical University from January 2023 to September 2024. RP was diagnosed by clinical symptoms on computed tomography (CT) scans and graded according to the Common Terminology Criteria for Adverse Events 5.0. Risk factors for RP were determined by univariate and multivariate logistic regression analysis.
Of the 42 patients included, 26 (61.9%) developed RP and 14 (33.3%) developed grade ≥ 2 RP. Grade ≥ 2 RP all occurred within 6 months of receiving TRT, and the median time from TRT to RP was 3.69 months (2-10 months). GTV ≥ 39 ml and total lung V20 ≥ 14.95% were found to be independent risk factors for RP development.
The strategy of combining a third-generation TKI with TRT significantly increases the incidence of RP, and the risk of RP in these patients can be reduced by adjusting lung radiation dosimetry parameters. In NSCLC patients taking triple-generation TKIs with primary tumour progression, the timing and dose of TRT addition must be strictly controlled to optimise the therapeutic strategy and reduce the incidence of RP.
Not applicable.
接受第三代表皮生长因子受体酪氨酸激酶抑制剂（EGFR TKIs）联合胸部放疗（TRT）的非小细胞肺癌（NSCLC）患者生存期显著延长，但放射性肺炎（RP）的发生率也会增加。我们研究的目的是调查接受第三代EGFR TKIs和TRT的NSCLC患者中RP的发生率及危险因素。
我们回顾性评估了2023年1月至2024年9月在宁夏医科大学总医院接受第三代EGFR TKIs和TRT的NSCLC患者。根据计算机断层扫描（CT）上的临床症状诊断RP，并按照不良事件通用术语标准5.0进行分级。通过单因素和多因素逻辑回归分析确定RP的危险因素。
纳入的42例患者中，26例（61.9%）发生RP，14例（33.3%）发生≥2级RP。≥2级RP均发生在接受TRT的6个月内，从TRT到发生RP的中位时间为3.69个月（2 - 10个月）。发现肿瘤靶区（GTV）≥39 ml和全肺V20≥14.95%是发生RP的独立危险因素。
第三代TKI联合TRT策略显著增加了RP的发生率，通过调整肺部放射剂量学参数可降低这些患者发生RP的风险。在接受三代TKIs且原发肿瘤进展的NSCLC患者中，必须严格控制加用TRT的时机和剂量，以优化治疗策略并降低RP的发生率。
不适用。
