CT Imaging Characteristics of Severe(Grade 3-4)Immune Checkpoint Inhibitor-Related Pneumonitis in Lung Cancer
10.3969/j.issn.1005-5185.2024.09.007
- VernacularTitle:肺癌重度(3～4级)免疫检查点抑制剂相关肺炎CT特征
- Author:
Bofeng ZHAO
1
;
Yamin ZHANG
;
Ping CHEN
;
Wei FENG
;
Jinpeng LIU
;
Kejun NAN
;
Baoying CHEN
Author Information
1. 西安国际医学中心医院影像诊疗中心,陕西 西安 710700
- Keywords:
Lung neoplasms;
Immune checkpoint inhibitors;
Tomography,X-ray computed;
Immune-related adverse event;
Diffuse alveolar damage/acute interstitial pneumonitis
- From:
Chinese Journal of Medical Imaging
2024;32(9):903-907
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To observe the clinical and CT features of severe immune checkpoint inhibitor-related pneumonitis(CIP)in lung cancer patients.Materials and Methods A total of 174 patients with lung cancer who received immune checkpoint inhibitor(PD-1/PD-L1 inhibitors)in Xi'an International Medical Center Hospital from September 1,2019 to March 31,2022 were retrospectively collected.Clinical and imaging features of patients with severe CIP were analyzed.Results There were 23 patients who met the diagnostic criteria of severe CIP.Among them,22 were male patients,15 were younger(＜65 years old),17 had a history of underlying lung disease,16 had a history of chemoradiotherapy and other treatments,and 21 had a history of combined radiotherapy and chemoradiotherapy.The median time from the initiation of immune checkpoint inhibitor to CIP was 128(74,348)days.19 patients were non-small cell carcinoma.CIP occurred in 16 patients with right lung cancer,15 had tumor central airway invasion,14 had radiographic features of diffuse alveolar injury/acute interstitial pneumonia pattern,and 20 died during follow-up.Conclusion Severe CIP is likely to occur in male lung cancer patients with a history of basic medical history and radiotherapy and chemotherapy.The clinical manifestations are varied,and the main imaging features are diffuse alveolar injury/acute interstitial pneumonia pattern,and the prognosis is poor.
