Effectiveness and safety of pirfenidone for radiation-induced lung injury in non-small cell lung cancer: a retrospective pilot study
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Le résumé fourni par la source
BACKGROUND: Radiotherapy (RT) remains a cornerstone in the treatment of thoracic malignancies; however, approximately one-third of patients with non-small cell lung cancer (NSCLC) develop Grade ≥ 2 radiation-induced lung injury (RILI). Despite its clinical significance, no pharmacologic standard of care has been established for RILI. Pirfenidone, an antifibrotic agent with anti-inflammatory and antioxidant properties, has demonstrated potential in preclinical models of RILI. This study aimed to evaluate the clinical efficacy and safety of pirfenidone in NSCLC patients with RILI following thoracic RT. METHODS: We retrospectively analyzed 33 NSCLC patients diagnosed with Grade ≥ 2 RILI who received pirfenidone (400 mg three times daily) in combination with standard-of-care treatment. The corticosteroid regimen included intravenous methylprednisolone (20-40 mg/day for 5 days), tapered and discontinued by Day 14. Radiologic response was assessed via monthly high-resolution computed tomography (HRCT), and symptoms were graded using common terminology criteria for adverse event(CTCAE) version 5.0. Dose-volume metrics (V5, V20, mean lung dose) were recorded and analyzed for correlation with RILI severity. RESULTS: Radiographic improvement was observed in 78.8% (26/33) of patients, with a trend toward increased response over time. No Grade ≥ 3 pirfenidone-related adverse events (AEs) were observed. One patient experienced transient Grade 3 thrombocytopenia attributed to prior chemotherapy. Univariate analysis showed no significant association between baseline characteristics and treatment response. Four patients with overlapping RILI and immune-related pneumonitis also showed clinical improvement. CONCLUSIONS: Our findings provide preliminary evidence supporting the clinical benefit and tolerability of pirfenidone for RILI in NSCLC patients. These results warrant further investigation in prospective controlled trials to establish its role in routine clinical practice.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Effectiveness and safety of pirfenidone for radiation-induced lung injury in non-small cell lung cancer: a retrospective pilot study
- Date Crossref
- 02/09/2025
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Guiyang Medical University pays non établi dans la noticeUniversité ou école supérieure
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Affiliated Hospital of Guizhou Medical University Department of Oncology pays non établi dans la noticeÉtablissement de santé
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The First People's Hospital of Guiyang Department of Oncology pays non établi dans la noticeÉtablissement de santé
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Wuhan Pulmonary Hospital pays non établi dans la noticeÉtablissement de santé
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School of Clinical Medicine Department of Oncology pays non établi dans la noticeUniversité ou école supérieure
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Qiandongnan Prefecture People's Hospital Department of Oncology pays non établi dans la noticeÉtablissement de santé
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Guiyang Pulmonary Hospital Department of Oncology pays non établi dans la noticeÉtablissement de santé
Guiyang Medical University, Department of Oncology — Affiliated Hospital of Guizhou Medical University et Department of Oncology — The First People's Hospital of Guiyang, avec 4 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.