{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T13:16:19Z","timestamp":1785244579038,"version":"3.55.0"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Radiation-induced lung injury (RILI) is a common and dose-limiting toxicity in patients with locally advanced esophageal squamous cell carcinoma (ESCC) receiving concurrent chemoradiotherapy (CCRT). Effective prophylactic agents are lacking. Tetrandrine, a bisbenzylisoquinoline alkaloid, has shown anti-inflammatory and anti-fibrotic properties in preclinical studies. This randomized controlled trial aims to evaluate the efficacy and safety of tetrandrine injection for preventing RILI in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a single-center, randomized, placebo-controlled, double-blind, phase II trial. A total of 100 eligible patients with locally advanced ESCC (T3-4N+M0) receiving definitive CCRT will be randomly assigned (1:1) to receive either intravenous tetrandrine (200\u2013300 mg\/day, 6 days per week for 12 weeks) or matching placebo. Radiotherapy dose is 50\u201350.4 Gy (1.8 Gy\/fraction) using IMRT, with concurrent docetaxel\/cisplatin. The primary endpoint is the incidence of grade \u22652 RILI according to CTCAE v5.0. Secondary endpoints include any-grade RILI, time to RILI onset, change in pulmonary function, and CCRT completion rate. Sample size calculation (40 evaluable per group) provides 80% power to detect a 15% absolute risk reduction (from 25% to 10%) with two-sided \u03b1=0.20. The protocol follows SPIRIT 2013 guidelines. Recruitment has not yet started.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This trial will generate preliminary evidence on the efficacy of tetrandrine for preventing RILI in ESCC patients. By adopting internationally accepted radiotherapy doses (50\u201350.4 Gy) and stringent lung dose constraints (V20  \u2264  30%, MLD &amp;lt; 20 Gy), the study provides a robust framework for comparing outcomes with global literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration:<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.chictr.org.cn\/bin\/project\/edit?pid=289682<\/jats:ext-link>\n                      , identifier ChiCTR2500111007.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1895499","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T12:57:35Z","timestamp":1785243455000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Tetrandrine injection for preventing radiation-induced lung injury in patients with locally advanced esophageal squamous cell carcinoma: a randomized controlled trial protocol"],"prefix":"10.3389","volume":"16","author":[{"given":"Qianqian","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Oncology, People\u2019s Hospital of Chongqing Hechuan","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingping","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Oncology, People\u2019s Hospital of Chongqing Hechuan","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wujie","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Oncology, People\u2019s Hospital of Chongqing Hechuan","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Oncology, People\u2019s Hospital of Chongqing Hechuan","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifang","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Oncology, People\u2019s Hospital of Chongqing Hechuan","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zijing","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Oncology, People\u2019s Hospital of Chongqing Hechuan","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanliang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Oncology, People\u2019s Hospital of Chongqing Hechuan","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"B2","article-title":"NCCN Clinical Practice Guidelines in Oncology: Esophageal and Esophagogastric Junction Cancers. 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