Early Prediction of Radiation Pneumonitis in Patients With Lung Cancer Treated With Immunotherapy Through Monitoring of Plasma Chemokines

作者：Lingyan Xiao, Ying Li, Sheng Wang, Lihua Fan, Qian Li, Zhijie Fan, Xi Wang, Li Ma, Duo Xu, Yulong Yu, Guang Han, Xianglin Yuan, Bo Liu · 发表于：International Journal of Radiation Oncology*Biology*Physics · 年份：2025 · DOI：10.1016/j.ijrobp.2025.02.011 · 被引用次数：9 · 研究领域：Cancer Immunotherapy and Biomarkers、Effects of Radiation Exposure、Lung Cancer Research Studies

PURPOSE: This study is aimed to identify biomarkers for symptomatic radiation pneumonitis (RP) in patients with lung cancer treated with immune checkpoint inhibitors (ICIs). METHODS AND MATERIALS: This multicenter, prospective study enrolled patients with lung cancer receiving thoracic radiation therapy (RT) between 2021 and 2023. Plasma cytokines were measured using Luminex assays. Cox proportional hazards model was used to identify risk factors and biomarkers for RP. Sensitivity analysis was conducted using Fine-Gray competing risk analyses. Receiver operating characteristic curves were used to assess the predictive value of the cytokines. RESULTS: A total of 214 patients receiving thoracic RT were included in this study, with 75 (35.05%) patients experiencing symptomatic RP. Among the 71 patients with prior ICI treatment, 32 (45.07%) developed symptomatic RP. Patients with prior ICI treatment had higher incidence of symptomatic RP and plasma chemokines than those without prior ICI treatment. For patients with prior ICI treatment, plasma CXCL10 before RT (hazard ratio [HR], 1.29; 95% CI, 1.03-1.61) and at 2 weeks (HR, 1.28; 95% CI, 1.03-1.59) and 4 weeks during RT (HR, 1.65; 95% CI, 1.19-2.28) were significantly associated with RP. The area under the curves (AUC) of plasma CXCL10 at baseline, 2 weeks and 4 weeks during RT were 0.625, 0.680, and 0.679, respectively. Plasma CXCL14 before RT and CXCL2 during RT were also predictors of RP. A risk score integrating CXCL10, CXCL1...