Chemoradiation-induced pneumonitis in patients with unresectable stage III non-small cell lung cancer : A systematic literature review and meta-analysis
Copyright © 2022 Elsevier B.V. All rights reserved..
INTRODUCTION: High-grade pneumonitis is a severe and potentially life-threatening adverse event associated with concurrent chemoradiation (cCRT) in patients with non-small cell lung cancer (NSCLC). The aim of this study was to summarize and quantify the incidence of severe (grade 3-5) cCRT-induced pneumonitis in unresectable stage III NSCLC patients.
METHODS: A systematic literature review and meta-analysis were performed in accordance with PRISMA guidelines. Published literature was searched for randomized controlled trials (RCTs), observational studies, and non-randomized trials from 2014 to April 2020. The primary outcome of interest was incidence of grade 3-5 pneumonitis.
RESULTS: Included were 17 studies for the review and 11 for the meta-analysis (1,788 participants); all studies examined radiation-related pneumonitis (RP). The pooled incidence of cCRT-induced grade 3-5 RP in unresectable stage III NSCLC patients was estimated to be 3.62% [95% confidence interval (CI): 1.65-6.21] in RCTs, 5.98% [95% CI: 2.26-12.91] in observational studies, and 7.85% [95% CI: 4.08-13.10] in observational studies using platinum-based doublet chemotherapies.
CONCLUSION: These results suggest the incidence of severe and fatal RP in patients with unresectable stage III NSCLC treated with cCRT ranges from 3.62% to 7.85%, with incidence varying by study design and chemotherapy regimen. Estimates of RP incidence were higher in the real-world setting compared to RCTs. These results can be used to contextualize the baseline risk of cCRT-induced pneumonitis in unresectable stage III NSCLC to better understand the adverse event of pneumonitis associated with novel immunotherapy treatments indicated for concomitant use with this modality.
| Errataetall: |
CommentIn: Lung Cancer. 2023 Sep;183:107309. - PMID 37494739 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:174 |
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| Enthalten in: |
Lung cancer (Amsterdam, Netherlands) - 174(2022) vom: 18. Dez., Seite 174-185 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Kuang, Yuting [VerfasserIn] |
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| Links: |
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| Themen: |
Concurrent chemoradiation |
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| Anmerkungen: |
Date Completed 16.12.2022 Date Revised 26.09.2023 published: Print-Electronic CommentIn: Lung Cancer. 2023 Sep;183:107309. - PMID 37494739 Citation Status MEDLINE |
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| doi: |
10.1016/j.lungcan.2022.06.005 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 500 | |a CommentIn: Lung Cancer. 2023 Sep;183:107309. - PMID 37494739 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 Elsevier B.V. All rights reserved. | ||
| 520 | |a INTRODUCTION: High-grade pneumonitis is a severe and potentially life-threatening adverse event associated with concurrent chemoradiation (cCRT) in patients with non-small cell lung cancer (NSCLC). The aim of this study was to summarize and quantify the incidence of severe (grade 3-5) cCRT-induced pneumonitis in unresectable stage III NSCLC patients | ||
| 520 | |a METHODS: A systematic literature review and meta-analysis were performed in accordance with PRISMA guidelines. Published literature was searched for randomized controlled trials (RCTs), observational studies, and non-randomized trials from 2014 to April 2020. The primary outcome of interest was incidence of grade 3-5 pneumonitis | ||
| 520 | |a RESULTS: Included were 17 studies for the review and 11 for the meta-analysis (1,788 participants); all studies examined radiation-related pneumonitis (RP). The pooled incidence of cCRT-induced grade 3-5 RP in unresectable stage III NSCLC patients was estimated to be 3.62% [95% confidence interval (CI): 1.65-6.21] in RCTs, 5.98% [95% CI: 2.26-12.91] in observational studies, and 7.85% [95% CI: 4.08-13.10] in observational studies using platinum-based doublet chemotherapies | ||
| 520 | |a CONCLUSION: These results suggest the incidence of severe and fatal RP in patients with unresectable stage III NSCLC treated with cCRT ranges from 3.62% to 7.85%, with incidence varying by study design and chemotherapy regimen. Estimates of RP incidence were higher in the real-world setting compared to RCTs. These results can be used to contextualize the baseline risk of cCRT-induced pneumonitis in unresectable stage III NSCLC to better understand the adverse event of pneumonitis associated with novel immunotherapy treatments indicated for concomitant use with this modality | ||
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Concurrent chemoradiation | |
| 650 | 4 | |a Non-small cell lung cancer | |
| 650 | 4 | |a Pneumonitis | |
| 700 | 1 | |a Pierce, Christine M |e verfasserin |4 aut | |
| 700 | 1 | |a Chang, Hsiu-Ching |e verfasserin |4 aut | |
| 700 | 1 | |a Sosinsky, Alexandra Z |e verfasserin |4 aut | |
| 700 | 1 | |a Deitz, Anne C |e verfasserin |4 aut | |
| 700 | 1 | |a Keller, Steven M |e verfasserin |4 aut | |
| 700 | 1 | |a Samkari, Ayman |e verfasserin |4 aut | |
| 700 | 1 | |a Uyei, Jennifer |e verfasserin |4 aut | |
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