接受胸部放射治疗和奥西默蒂尼布的患者的肺炎:一个多机构研究
Leou Ismael Banla1, Alice Tzeng2, John P Baillieul3
1Harvard Radiation Oncology Program, Boston, Massachusetts.
JTO clinical and research reports
|September 21, 2023
概括
胸部放射治疗 (TRT) 结合奥西默提尼布治疗晚期非小细胞肺癌 (NSCLC) 的肺炎的风险很低,但很大. 在TRT期间较高的平均肺剂量增加了肺炎的风险.
科学领域:
- 在瘤学瘤学.
- 辐射瘤学 辐射瘤学
- 肺部病理学 肺部病理学
背景情况:
- 胸部放射治疗 (TRT) 越来越多地与奥西默提尼布一起用于高级非小细胞肺癌 (NSCLC).
- 在这种患者群体中,肺炎的风险和促成因素尚未得到充分确立.
研究的目的:
- 为了调查晚期NSCLC患者肺炎的发病率和风险因素,这些患者同时接受 osimertinib 和 TRT.
- 评估在TRT期间保留或继续服用奥西默蒂尼布对肺炎风险的影响.
主要方法:
- 对102名患有晚期NSCLC的患者进行了多机构的回顾性分析,这些患者接受了osimertinib和TRT的治疗.
- 收集的数据包括临床特征,奥西默蒂尼布治疗中断以及肺炎发病率和程度 (CTCAE v5.0).
- 后勤回归确定了2级或更高肺炎的风险因素.
主要成果:
- 13.7%的患者患有2级或更高的肺炎,中位数发生在TRT后3.2个月.
- 在TRT期间继续或保持奥西默提尼布的患者之间没有观察到肺炎风险的显著差异.
- 平均肺剂量与2级+肺炎的风险增加有显著关联 (OR=1.19,p=0.021).
- 严重的肺炎 (3-5级) 在4.9%的患者中发生.
结论:
- 虽然整体肺炎的发病率相对较低,但严重的毒性是可能的.
- 平均肺剂量是与接受 osimertinib 和 TRT 的患者肺炎风险相关的关键因素.
- 这些发现有助于临床决策,制定并发治疗策略.
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