Radiographic features and prognosis of early- and late-onset non-small cell lung cancer immune checkpoint inhibitor-related pneumonitis.
Radiographic features and prognosis of early- and late-onset non-small cell lung cancer immune checkpoint inhibitor-related pneumonitis.
复制标题
早发和晚发非小细胞肺癌免疫检查点抑制剂相关肺炎的影像学特征及预后
DOI：
10.1186/s12885-021-08353-y
复制
发表时间：
2021-05-29
期刊：
影响因子：
3.8
通讯作者：
Xue X
中科院分区：
文献类型：
--
作者：
Huang A;Xu Y;Zang X;Wu C;Gao J;Sun X;Xie M;Ma X;Deng H;Song J;Ren F;Pang L;Qian J;Yu Z;Wan S;Chen Y;Pan L;Zhuang G;Liu S;Xue X
背景
免疫疗法正在成为非小细胞肺癌（NSCLC）的标准治疗。检查点相关性肺炎（CIP）是一种罕见且可能危及生命的事件，可在肿瘤免疫治疗期间的任何时间发生。但在不同时期，CIP的影像学表现及预后可能有所不同。本研究旨在探讨早发型和晚发型免疫相关性肺炎的影像学特征和预后。
方法
我们回顾性分析了677例接受免疫治疗的NSCLC患者的临床资料，确定了32例CIP患者，分析了临床和影像学资料，总结了早发型和晚发型CIP的影像学特征和预后。
结果
CIP的发生率为4.7%，中位发病时间为10周，死亡率为28.1%。其中，CIP包括14例早发病例，其中≥ 3级CIP占92.9%，主要影像学表现为机化性肺炎（OP）样，死亡率为50.0%。迟发性CIP 18例，其中≥ 3级占50.0%，影像学表现以非特异性间质性肺炎（NSIP）样为主，病死率为11.1%。早发组总生存率明显低于晚发组（P0.05）。
结论
早发性CIP病例的不良事件通用术语标准（CTCAE v5.0）分级较高，主要表现为OP样影像学模式;而迟发性CIP病例的CTCAE分级较低，主要表现为NSIP样影像学模式。早发性CIP组预后较晚发性CIP组差。我们相信，这项研究将有助于临床医生对CIP患者的早期诊断和治疗方法的选择。
Background
Immunotherapy is becoming a standard of care for non-small cell lung cancer (NSCLC). Checkpoint inhibitor-associated pneumonia (CIP) is a rare and potentially life-threatening event that can occur at any time during tumor immunotherapy. However, there may be differences in the radiological patterns and prognosis of CIP during different periods. This study aimed to investigate the radiographic features and prognosis of early- and late-onset immune-related pneumonitis.
Methods
We retrospectively analyzed the clinical data of 677 NSCLC patients receiving immunotherapy to identify 32 patients with CIP, analyzed the clinical and radiographic data, and summarized the radiological features and prognosis of early- and late-onset CIP.
Results
CIP had an incidence of 4.7%, a median onset time of 10 weeks, and a mortality of 28.1%. Among these, CIP included 14 early-onset cases, where grade ≥ 3 CIP accounted for 92.9%, main radiographic pattern was organizing pneumonia (OP)-like pattern, and mortality was 50.0%. We also identified 18 late-onset CIPs, where grade ≥ 3 CIP accounted for 50.0%, main radiographic pattern was nonspecific interstitial pneumonia (NSIP)-like pattern, and mortality was 11.1%. The overall survival rate of the early-onset group was significantly lower than that of the late-onset group (P 0.05).
Conclusion
Early-onset CIP cases were higher in the Common Terminology Criteria for Adverse Events (CTCAE v5.0) grade and mainly presented with an OP-like radiographic pattern; whereas, late-onset CIP cases were lower in CTCAE grade and mainly presented with an NSIP-like radiographic pattern. Finally, the prognosis of the early-onset CIP group was poorer than that of the late-onset CIP group. We believe that this study will be helpful for clinicians for making early diagnosis and deciding treatment modalities for patients with CIP.
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DOI：
10.1183/16000617.0058-2019
发表时间：
2019-09-30
期刊：
European respiratory review : an official journal of the European Respiratory Society
影响因子：
--
作者：
通讯作者：
--
影响因子：
0.9
作者：
Costa RB;Benson A;Yaghmai V;Costa RLB;Zhou H;Behdad A;Kaplan JB;Sadim M;Talamantes S;Kalyan A
通讯作者：
Kalyan A
影响因子：
20.4
作者：
Teraoka, Shunsuke;Fujimoto, Daichi;Tomii, Keisuke
通讯作者：
Tomii, Keisuke
影响因子：
24.7
作者：
Shi, Yuankai;Su, Hang;Liu, Peng
通讯作者：
Liu, Peng
影响因子：
4.6
作者：
Pozzessere, Chiara;Bouchaab, Hasna;Beigelman-Aubry, Catherine
通讯作者：
Beigelman-Aubry, Catherine