{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:52:37Z","timestamp":1787755957845,"version":"build-2784847793"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2021,6,14]],"date-time":"2021-06-14T00:00:00Z","timestamp":1623628800000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The aim of this study is to analyze the incidence and risk factors for pneumonitis when immune checkpoint inhibitors (ICIs) are combined with palliative thoracic radiotherapy (RT) for lung cancer. We retrospectively evaluated 29 patients with lung cancer who received ICIs after palliative thoracic RT (30\u00a0Gy in 10 fractions). Their ICIs were pembrolizumab (n\u2009=\u200917), nivolumab (n\u2009=\u20098) and atezolizumab (n\u2009=\u20094). Median follow-up period was 10\u00a0months. The median interval between starting RT and starting ICI was 25\u00a0days. Pneumonitis events were grade 1 (n\u2009=\u200910; 34%), grade 2 (n\u2009=\u20094; 14%) and grade 3 (n\u2009=\u20093; 10%). Obstructive pneumonia was significantly associated with grade\u2009\u2265\u20092 pneumonitis (P\u2009=\u20090.036). Age, sex, ICI agent, interval between RT and ICI and history of ICI before RT were not associated with grade\u2009\u2265\u20092 pneumonitis. Tumor volume; Brinkman index; dosimetric factors, such as lung V5, V10, V20, V30 and mean lung dose (MLD); lactate dehydrogenase; and C-reactive protein did not significantly differ between the grade\u2009\u2264\u20091 and grade\u2009\u2265\u20092 pneumonitis groups. Levels of sialylated carbohydrate antigen KL-6 were evaluated in 27 patients before RT; they significantly differed between patients with grade\u2009\u2264\u20092 pneumonitis (mean: 431\u00a0U\/ml) and those with grade\u2009\u2265\u20093 pneumonitis (mean: 958\u00a0U\/ml; P\u2009&amp;lt;\u00a00.001). Patients who receive ICI after palliative thoracic RT should be carefully followed-up, especially those who have had obstructive pneumonia or high KL-6 levels.<\/jats:p>","DOI":"10.1093\/jrr\/rrab051","type":"journal-article","created":{"date-parts":[[2021,5,27]],"date-time":"2021-05-27T11:53:38Z","timestamp":1622116418000},"page":"669-675","source":"Crossref","is-referenced-by-count":12,"title":["Incidence and risk factors for pneumonitis among patients with lung cancer who received immune checkpoint inhibitors after palliative thoracic radiotherapy"],"prefix":"10.1093","volume":"62","author":[{"given":"Satoshi","family":"Saito","sequence":"first","affiliation":[{"name":"Departments of Radiation Oncology, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takanori","family":"Abe","sequence":"additional","affiliation":[{"name":"Departments of Radiation Oncology, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Misaki","family":"Iino","sequence":"additional","affiliation":[{"name":"Departments of Radiation Oncology, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomomi","family":"Aoshika","sequence":"additional","affiliation":[{"name":"Departments of Radiation Oncology, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Ryuno","sequence":"additional","affiliation":[{"name":"Departments of Radiation Oncology, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiro","family":"Ohta","sequence":"additional","affiliation":[{"name":"Departments of Radiation Oncology, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsunobu","family":"Igari","sequence":"additional","affiliation":[{"name":"Departments of Radiation Oncology, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryuta","family":"Hirai","sequence":"additional","affiliation":[{"name":"Departments of Radiation Oncology, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Kumazaki","sequence":"additional","affiliation":[{"name":"Departments of 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