Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Oncology Letters
      • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Biomedical Reports
      • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • Information for Authors
    • Information for Reviewers
    • Information for Librarians
    • Information for Advertisers
    • Conferences
  • Language Editing
Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • For Authors
    • For Reviewers
    • For Librarians
    • For Advertisers
    • Conferences
  • Language Editing
Login Register Submit
  • This site uses cookies
  • You can change your cookie settings at any time by following the instructions in our Cookie Policy. To find out more, you may read our Privacy Policy.

    I agree
Search articles by DOI, keyword, author or affiliation
Search
Advanced Search
presentation
Oncology Letters
Join Editorial Board Propose a Special Issue
Print ISSN: 1792-1074 Online ISSN: 1792-1082
Journal Cover
April-2025 Volume 29 Issue 4

Full Size Image

Sign up for eToc alerts
Recommend to Library

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

Medicine International

An International Open Access Journal Devoted to General Medicine.

Journal Cover
April-2025 Volume 29 Issue 4

Full Size Image

Sign up for eToc alerts
Recommend to Library

  • Article
  • Citations
    • Cite This Article
    • Download Citation
    • Create Citation Alert
    • Remove Citation Alert
    • Cited By
  • Similar Articles
    • Related Articles (in Spandidos Publications)
    • Similar Articles (Google Scholar)
    • Similar Articles (PubMed)
  • Download PDF
  • Download XML
  • View XML
Article Open Access

Timing of thoracic radiotherapy combined with immunotherapy influences pulmonary injury

  • Authors:
    • Jing Yuan
    • Qiteng Liu
    • Xuan Liu
    • Xianbin Zheng
    • Xianxiu Nan
    • Xinjue Shi
    • Siyao Zhong
    • Bin Sun
    • Pan Hao
    • Sen Wang
    • Yuyan Gao
  • View Affiliations / Copyright

    Affiliations: Department of Radiation Oncology, Beijing Luhe Hospital, Capital Medical University, Beijing 101100, P.R. China, Department of Radiology, Beijing Luhe Hospital, Capital Medical University, Beijing 101100, P.R. China, Department of Neurosurgery, Beijing Luhe Hospital, Capital Medical University, Beijing 101100, P.R. China
    Copyright: © Yuan et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 206
    |
    Published online on: March 4, 2025
       https://doi.org/10.3892/ol.2025.14953
  • Expand metrics +
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )
Cited By (CrossRef): 0 citations Loading Articles...

This article is mentioned in:



Abstract

The present study aimed to assess the impact of chest radiotherapy combined with immunotherapy at different time points in lung injury. This retrospective study analyzed 35 patients with thoracic tumors (29 lung cancer cases and 6 esophageal cancer cases) who received radiotherapy combined with immunotherapy between January 2021 and December 2023 at at Capital Medical University, affiliated with Beijing Luhe Hospital (Beijing, China), with a median follow‑up time of 21 months. Patients were divided into two groups: Group A (sequential, n=17), who received immunotherapy 2 weeks to 6 months before or after radiotherapy, and group B (synchronous, n=18), who received immunotherapy within 2 weeks before or after radiotherapy. Furthermore, the incidence and severity of lung injury, especially pneumonitis, were also compared. Moreover, risk factors for lung injury, as well as  3‑year overall survival (OS) rates for stage III and IV lung cancer, were evaluated. There were no significant differences in tumor location, stage, age, tumor type, Eastern Cooperative Oncology Group score or sex between groups. The proportion of PD‑1 in group A was higher, while the proportion of PD‑L1 was lower, compared with that in group B. Furthermore, radiotherapy techniques and dosimetric parameters were also similar. Moreover, there were no significant differences in onset time between esophagitis, anemia or pneumonitis between the two groups. However, incidence of grade 3 or higher pneumonitis was 0.0% in the sequential group and 23.5% in the synchronous group, which was significantly different. Univariate analysis identified lung mean dose and the percentage volume receiving ≥30 Gy (V30) as significant risk factors, whereas multivariate analysis revealed that V30 was an independent prognostic factor. The 3‑year OS rates for stage III and IV lung cancer were 44.8 and 22.5%, respectively. In conclusion, the present study revealed that radiotherapy combined with immunotherapy increases the survival rate; however, it also elevates the risk of grade 3+ pneumonitis, especially within 2 weeks of concurrent therapy. As pneumonia occurs at around 3 months after radiotherapy, a follow‑up time of 2‑4 months post‑treatment is recommended.
View Figures

Figure 1

Figure 2

View References

1 

National Comprehensive Cancer Network (NCCN), . Non-Small Cell Lung Cancer (NCCN Guidelines®). NCCN; Plymouth Meeting, PA: 2024

2 

Patel RB, Hernandez R, Carlson P, Grudzinski J, Bates AM, Jagodinsky JC, Erbe A, Marsh IR, Arthur I, Aluicio-Sarduy E, et al: Low-dose targeted radionuclide therapy renders immunologically cold tumors responsive to immune checkpoint blockade. Sci Transl Med. 13:eabb36312021. View Article : Google Scholar : PubMed/NCBI

3 

Antonia SJ, Villegas A, Daniel D, Vicente D, Murakami S, Hui R, Kurata T, Chiappori A, Lee KH, de Wit M, et al: PACIFIC investigators. Overall survival with durvalumab after chemoradiotherapy in stage III NSCLC. N Engl J Med. 379:2342–2350. 2018. View Article : Google Scholar : PubMed/NCBI

4 

Stucci S, Palmirotta R, Passarelli A, Silvestris E, Argentiero A, Lanotte L, Acquafredda S, Todisco A and Silvestris F: Immune-related adverse events during anticancer immunotherapy: Pathogenesis and management. Oncol Lett. 14:5671–5680. 2017.PubMed/NCBI

5 

Wang CL, Ho AS and Cheng CC, Sie ZL, Peng CL, Chang J and Cheng CC: Radiotherapy enhances CXCR3highCD8+ T cell activation through inducing IFNγ-mediated CXCL10 and ICAM-1 expression in lung cancer cells. Cancer Immunol Immunother. 72:1865–1880. 2023. View Article : Google Scholar : PubMed/NCBI

6 

U.S. Department of Health and Human Services, . Common Terminology Criteria for Adverse Events Version 5.0 (CTCAE v5.0).

7 

Chang W: R Graphics Cookbook. O'Reilly Media; 2013

8 

Goldstraw P, Crowley J, Chansky K, Rami-Porta R, Asamura H, Eberhardt WE, Nicholson AG, Groome P, Mitchell A, Bolejack V, et al: The IASLC lung cancer staging project: Proposals for the revision of the TNM stage groupings in the forthcoming (Eighth) edition of the TNM classification for lung cancer. J Thorac Oncol. 10:1260–1271. 2015.

9 

Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET and Carbone PP: Toxicity and response criteria of the Eastern cooperative oncology group. Am J Clin Oncol. 5:649–655. 1982. View Article : Google Scholar : PubMed/NCBI

10 

Shaverdian N, Lisberg AE, Bomazyan K, Veruttipong D, Goldman JW, Formenti SC, Garon EB and Lee P: Previous radiotherapy and the clinical activity and toxicity of pembrolizumab in the treatment of non-small cell lung cancer: A secondary analysis of the KEYNOTE-001 phase 1 trial. Lancet Oncol. 8:895–903. 2017. View Article : Google Scholar : PubMed/NCBI

11 

Ross GM: Induction of cell death by radiotherapy. Endocr Relat Cancer. 6:41–44. 1999. View Article : Google Scholar : PubMed/NCBI

12 

Vinod SK and Hau E: Radiotherapy treatment for lung cancer: Current status and future directions. Respimlogy. 25 (Suppl 2):S61–S71. 2020. View Article : Google Scholar

13 

Uribe-Herranz M, Rafail S, Beghi S, Gil-de-Gómez L, Verginadis I, Bittinger K, Pustylnikov S, Pierini S, Perales-Linares R, Blair IA, et al: Gut microbiota modulate dendritic cell antigen presentation and radiotherapy-induced antitumor immune response. J Clin Invest. 130:466–479. 2020. View Article : Google Scholar : PubMed/NCBI

14 

Liu L, Bai H, Wang C, Seery S, Wang Z, Duan J, Li S, Xue P, Wang G, Sun Y, et al: Efficacy and safety of first-line lmmunotherapy combinations for advanced NSCLC: A systematic review and network meta-analysis. J Thorac Oncol. 16:1099–1117. 2021. View Article : Google Scholar : PubMed/NCBI

15 

Hen'era FG, Irving M, Kandalaft LE and Coukos G: Rational combinations of immunotherapy with radiotherapy inovarian cancer. Lancet Oncol. 20:e417–e433. 2019. View Article : Google Scholar

16 

Nishino M, Giobbie-Hurder A, Hatabu H, Ramaiya NH and Hodi F: Incidence of programmed cell death 1 inhibitor-related pneumonitis in patients with advanced cancer: A systematic review and meta-analysis. JAMA Oncol. 2:1607–1616. 2016. View Article : Google Scholar : PubMed/NCBI

17 

Jabbour SK, Berman AT, Decker RH, Lin Y, Feigenberg SJ, Gettinger SN, Aggarwal C, Langer CJ, Simone CB, Bradley JD, et al: Prospective phase I multi-institutional trial of PD-1 blockade with pembrolizumab during concurrent chemoradiation for locally advanced, unresectable non-small cell lung cancer. J Clin Oncol. 37:85112019. View Article : Google Scholar

18 

Lu X, Wang J, Zhang T, Zhou Z, Deng L, Wang X, Wang W, Liu W, Tang W, Wang Z, et al: Comprehensive pneumonitis profile of thoracic radiotherapy followed by immune checkpoint inhibitor and risk factors for radiation recall pneumonitis in lung cancer. Front Immunol. 13:9187872022. View Article : Google Scholar : PubMed/NCBI

19 

Huang HY, Gong HY and Song QB: Influencing factors of pneumonitis in the period of thoracic radiotherapy combined with immunotherapy. J Int Oncol. 50:102–106. 2023.(In Chinese).

20 

Chen K and Sun B: Incidence and risk of PD-1/PD-L1 inhibitor-associated pneumonia in advance cancer patients: A meta-analysis. Zhongguo Fei Ai Za Zhi. 23:927–940. 2020.(In Chinese). PubMed/NCBI

21 

Delaunay M, Cadranel J, Lusque A, Meyer N, Gounant V, Moro-Sibilot D, Michot JM, Raimbourg J, Girard N, Guisier F, et al: Immune checkpoint inhibitors associated with interstitial lung disease in cancer patients. Eur Respir J. 50:17000502017. View Article : Google Scholar : PubMed/NCBI

22 

Lu XT, Wang JY, Zhang T, Zhou Z, Deng L, Wang X, Wang W, Liu W, Tang W, Wang Z, et al: Comprehensive Pneumonitis Profile of Thoracic Radiotherapy Followed by Immune Checkpoint Inhibitor and Risk Factors for Radiation Recall Pneumonitis in Lung Cancer. Front Immunol. 13:9187872022. View Article : Google Scholar : PubMed/NCBI

23 

Saito G, Oya Y, Taniguchi Y, Kawachi H, Daichi F, Matsumoto H, Iwasawa S, Suzuki H, Niitsu T, Miyauchi E, et al: Real-world survey of pneumonitis/radiation pneumonitis among patients with locally advanced non-small cell lung cancer treated with chemoradiotherapy after durvalumab approval: A multicenter retrospective cohort study (HOPE-005/CRIMSON). J Clin Oncol. 38:90392020. View Article : Google Scholar

24 

Chen Y, Liu X, Huang Z, Zhao K, Wang Y, Ren F, Yu J and Meng X: Safety of thoracic radiotherapy after PD-(L)1 inhibitor treatment in patients with lung cancer. Cancer Med. 10:8518–8529. 2021. View Article : Google Scholar : PubMed/NCBI

25 

Lin SH, Lin Y, Yao L, Kalihor N, Carter BW, Altan M, Blumenschein G, Byers LA, Fossella F, Gibbons DL, et al: Phase II Trial of Concurrent Atezolizumab With Chemoradiation for Unresectable NSCLC. J Thorac Oncol. 15:248–257. 2020. View Article : Google Scholar : PubMed/NCBI

Related Articles

  • Abstract
  • View
  • Download
  • Twitter
Copy and paste a formatted citation
Spandidos Publications style
Yuan J, Liu Q, Liu X, Zheng X, Nan X, Shi X, Zhong S, Sun B, Hao P, Wang S, Wang S, et al: Timing of thoracic radiotherapy combined with immunotherapy influences pulmonary injury. Oncol Lett 29: 206, 2025.
APA
Yuan, J., Liu, Q., Liu, X., Zheng, X., Nan, X., Shi, X. ... Gao, Y. (2025). Timing of thoracic radiotherapy combined with immunotherapy influences pulmonary injury. Oncology Letters, 29, 206. https://doi.org/10.3892/ol.2025.14953
MLA
Yuan, J., Liu, Q., Liu, X., Zheng, X., Nan, X., Shi, X., Zhong, S., Sun, B., Hao, P., Wang, S., Gao, Y."Timing of thoracic radiotherapy combined with immunotherapy influences pulmonary injury". Oncology Letters 29.4 (2025): 206.
Chicago
Yuan, J., Liu, Q., Liu, X., Zheng, X., Nan, X., Shi, X., Zhong, S., Sun, B., Hao, P., Wang, S., Gao, Y."Timing of thoracic radiotherapy combined with immunotherapy influences pulmonary injury". Oncology Letters 29, no. 4 (2025): 206. https://doi.org/10.3892/ol.2025.14953
Copy and paste a formatted citation
x
Spandidos Publications style
Yuan J, Liu Q, Liu X, Zheng X, Nan X, Shi X, Zhong S, Sun B, Hao P, Wang S, Wang S, et al: Timing of thoracic radiotherapy combined with immunotherapy influences pulmonary injury. Oncol Lett 29: 206, 2025.
APA
Yuan, J., Liu, Q., Liu, X., Zheng, X., Nan, X., Shi, X. ... Gao, Y. (2025). Timing of thoracic radiotherapy combined with immunotherapy influences pulmonary injury. Oncology Letters, 29, 206. https://doi.org/10.3892/ol.2025.14953
MLA
Yuan, J., Liu, Q., Liu, X., Zheng, X., Nan, X., Shi, X., Zhong, S., Sun, B., Hao, P., Wang, S., Gao, Y."Timing of thoracic radiotherapy combined with immunotherapy influences pulmonary injury". Oncology Letters 29.4 (2025): 206.
Chicago
Yuan, J., Liu, Q., Liu, X., Zheng, X., Nan, X., Shi, X., Zhong, S., Sun, B., Hao, P., Wang, S., Gao, Y."Timing of thoracic radiotherapy combined with immunotherapy influences pulmonary injury". Oncology Letters 29, no. 4 (2025): 206. https://doi.org/10.3892/ol.2025.14953
Follow us
  • Twitter
  • LinkedIn
  • Facebook
About
  • Spandidos Publications
  • Careers
  • Cookie Policy
  • Privacy Policy
How can we help?
  • Help
  • Live Chat
  • Contact
  • Email to our Support Team