Abstract Objective To investigate the influence of radiotherapy with concurrent oral epidermal growth factor receptor (EGFR) and tyrosine kinase inhibitor (TKI) for advanced non-small cell lung cancer (NSCLC) on the incidence of interstitial lung disease (ILD),and to analyze the risk factors for the pathogenesis of ILD. Methods The incidence of ILD in 72 patients with NSCLC who were admitted to Department of Radiotherapy Oncology of Lu′an Hospital of Traditional Chinese Medicine and treated with radiotherapy with concurrent oral EGFR-TKI from January 2010 to January 2014 was analyzed retrospectively,and some patients were selected as controls to compare the difference in the incidence of ILD between the TKI concurrent radiotherapy group and the other groups. The univariate analysis using chi-square test and multivariate logistic regression analysis were applied to analyze the risk factors for the incidence of ILD in the patients receiving TKI concurrent radiotherapy. Results The TKI concurrent radiotherapy group had a significantly higher incidence rate of ILD than the palliative chemotherapy group,single TKI group,and concurrent chemoradiotherapy group (19.4% vs. 2.5%,12%,and 7.5%,P=0.045).The multivariate regression analysis showed that male sex,long-term smoking,underlying lung disease,tumor volume>5 cm,and application of conventional radiotherapy were the risk factors for the pathogenesis of ILD in the TKI concurrent radiotherapy group. Conclusions Radiotherapy with concurrent TKI for advanced NSCLC may increase the incidence of ILD.
Liang Hui,Ding Meiqian,Wu Ningbo et al. A clinical study of interstitial lung disease induced by TKI concurrent radiotherapy[J]. Chinese Journal of Radiation Oncology, 2016, 25(2): 131-134.
Liang Hui,Ding Meiqian,Wu Ningbo et al. A clinical study of interstitial lung disease induced by TKI concurrent radiotherapy[J]. Chinese Journal of Radiation Oncology, 2016, 25(2): 131-134.
[1]Steuer CE,Khuri FR,Ramalingam SS.The next generation of epidermal growth factor receptor tyrosine kinase inhibitors in the treatment of lung cancer[J].Cancer,2015,121(8):E1-E6.DOI:10.1002/cncr.29139. [2]Faria SL.Role of radiotherapy in metastatic non-small cell lung cancer[J].Front Oncol,2014,4:229.DOI:10.3389/fonc.2014.00229. [3]Fukuoka M,Yano S,Giaccone G,et al. Multi-institutional randomized phase Ⅱ trial of gefitinib for previously treated patients with advanced non-small-cell lung cancer[J].J Clin Oncol,2003,21(12):2237-2246.DOI:10.1200/JCO.2003.10.038. [4]Shepherd FA,Pereira RJ,Ciuleanu T,et al. Erlotinib in previously treated non-small-cell lung cancer[J].N Engl J Med,2005,353(2):123-132.DOI:10.1056/NEJMoa050753. [5]Bowles DW,Weickhardt A,Jimeno A.Afatinib for the treatment of patients with EGFR-positive non-small cell lung cancer[J].Drugs Today (Barc),2013,49(9):523-535.DOI:10.1358/dot.2013.49.9.2016610. [6]Zakowski MF.Lung cancer in the era of targeted therapy:a cytologist′s perspective[J].Arch Pathol Lab Med,2013,137(12):1816-1821.DOI:10.5858/arpa.2013-0029-RA. [7]Lin Y,Wang X,Jin H.EGFR-TKI resistance in NSCLC patients:mechanisms and strategies[J].Am J Cancer Res,2014,4(5):411-435. [8]Taira N,Doihara H,Oota T,et al. Gefitinib,an epidermal growth factor receptor blockade agent,shows additional or synergistic effects on the radiosensitivity of esophageal cancer cells in vitro[J].Acta Med Okayama,2006,60(1):25-34. [9]Park JS,Jun HJ,Cho MJ,et al. Radiosensitivity enhancement by combined treatment of celecoxib and gefitinib on human lung cancer cells[J].Clin Cancer Res,2006,12(16):4989-4999.DOI:10.1158/1078-0432.CCR-05-2259. [10]Okamoto I,Takahashi T,Okamoto H,et al. Single-agent gefitinib with concurrent radiotherapy for locally advanced non-small cell lung cancer harboring mutations of the epidermal growth factor receptor[J].Lung Cancer,2011,72(2):199-204.DOI:10.1016/j.lungcan.2010.08.016. [11]Chang CC,Chi KH,Kao SJ,et al. Upfront gefitinib/erlotinib treatment followed by concomitant radiotherapy for advanced lung cancer:a mono-institutional experience[J].Lung Cancer,2011,73(2):189-194.DOI:10.1016/j.lungcan.2010.12.007. [12]Nanda A,Dias-Santagata DC,Stubbs H,et al. Unusual tumor response and toxicity from radiation and concurrent erlotinib for non-small-cell lung cancer[J].Clin Lung Cancer,2008,9(5):285-287.DOI:10.3816/CLC.2008.n.044. [13]Hsieh CH,Chang HT,Lin SC,et al. Toxic risk of stereotactic body radiotherapy and concurrent helical tomotherapy followed by erlotinib for non-small-cell lung cancer treatment-case report[J].BMC Cancer,2010,10(1):696.DOI:10.1186/1471-2407-10-696. [14]Takeda M,Okamoto I,Nakagawa K.Pooled safety analysis of EGFR-TKI treatment for EGFR mutation-positive non-small cell lung cancer[J].Lung Cancer,2015,88(1):74-79.DOI:10.1016/j.lungcan.2015.01.026. [15]Zhang J,Zhan Y,Ouyang M,et al. Fatal interstitial lung disease associated with icotinib[J].J Thorac Dis,2014,6(12):E267-E271.DOI:10.3978/j.issn.2072-1439.2014.10.24. [16]Usui K,Ushijima T,Tanaka Y,et al. The frequency of epidermal growth factor receptor mutation of nonsmall cell lung cancer according to the underlying pulmonary diseases[J].Pulm Med,2011,2011:290132.DOI:10.1155/2011/290132. [17]Atmaca A,Al-Batran SE,Allguer M,et al. Afatinib with concurrent radiotherapy in a patient with metastatic non-small cell lung cancer[J].Oncol Res Treat,2014,37(5):262-265.DOI:10.1159/000362488. [18]Ando M,Okamoto I,Yamamoto N,et al. Predictive factors for interstitial lung disease,antitumor response,and survival in non-small-cell lung cancer patients treated with gefitinib[J].J Clin Oncol,2006,24(16):2549-2556.DOI:10.1200/JCO.2005.04.9866. [19]Niho S,Goto K,Yoh K,et al. Interstitial shadow on chest CT is associated with the onset of interstitial lung disease caused by chemotherapeutic drugs[J].Jpn J Clin Oncol,2006,36(5):269-273.DOI:10.1093/jjco/hyl021.
2016, Vol. 25 
