DOI QR코드

DOI QR Code

Radiation Recall Pneumonitis: Imaging Appearance and Differential Considerations

  • Nahyun Celina Jo (Department of Diagnostic Radiology, University of Texas Medical Branch) ;
  • Girish S. Shroff (Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center) ;
  • Jitesh Ahuja (Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center) ;
  • Rishi Agrawal (Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center) ;
  • Melissa C. Price (Department of Radiology, Division of Thoracic Imaging and Intervention, Massachusetts General Hospital) ;
  • Carol C. Wu (Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center)
  • 투고 : 2024.04.03
  • 심사 : 2024.07.24
  • 발행 : 2024.09.01

초록

Radiation recall pneumonitis is an inflammatory reaction of previously radiated lung parenchyma triggered by systemic pharmacological agents (such as chemotherapy and immunotherapy) or vaccination. Patients present with non-specific symptoms such as cough, shortness of breath, or hypoxia soon after the initiation of medication or vaccination. Careful assessment of the patient's history, including the thoracic radiation treatment plan and timing of the initiation of the triggering agent, in conjunction with CT findings, contribute to the diagnosis. Once a diagnosis is established, treatment includes cessation of the causative medication and/or initiation of steroid therapy. Differentiating this relatively rare entity from other common post-therapeutic complications in oncology patients, such as recurrent malignancy, infection, or medication-induced pneumonitis, is essential for guiding downstream clinical management.

키워드

참고문헌

  1. Kimura T, Matsuura K, Murakami Y, Hashimoto Y, Kenjo M, Kaneyasu Y, et al. CT appearance of radiation injury of the lung and clinical symptoms after stereotactic body radiation therapy (SBRT) for lung cancers: are patients with pulmonary emphysema also candidates for SBRT for lung cancers? Int J Radiat Oncol Biol Phys 2006;66:483-491
  2. Shultz DB, Trakul N, Abelson JA, Murphy JD, Maxim PG, Le QT, et al. Imaging features associated with disease progression after stereotactic ablative radiotherapy for stage I non-small-cell lung cancer. Clin Lung Cancer 2014;15:294-301.e3
  3. Henderson MA, Hoopes DJ, Fletcher JW, Lin PF, Tann M, Yiannoutsos CT, et al. A pilot trial of serial 18F-fluorodeoxyglucose positron emission tomography in patients with medically inoperable stage I non-small-cell lung cancer treated with hypofractionated stereotactic body radiotherapy. Int J Radiat Oncol Biol Phys 2010;76:789-795
  4. McGovern K, Ghaly M, Esposito M, Barnaby K, Seetharamu N. Radiation recall pneumonitis in the setting of immunotherapy and radiation: a focused review. Future Sci OA 2019;5:FSO378
  5. Shibaki R, Akamatsu H, Fujimoto M, Koh Y, Yamamoto N. Nivolumab induced radiation recall pneumonitis after two years of radiotherapy. Ann Oncol 2017;28:1404-1405
  6. Riviere P, Sumner W, Cornell M, Sandhu A, Murphy JD, Hattangadi-Gluth J, et al. Radiation recall pneumonitis after treatment with checkpoint blockade immunotherapy: a case series and review of literature. Front Oncol 2021;11:662954
  7. Antonia SJ, Villegas A, Daniel D, Vicente D, Murakami S, Hui R, et al. Durvalumab after chemoradiotherapy in stage III non-small-cell lung cancer. N Engl J Med 2017;377:1919-1929
  8. Antonia SJ, Villegas A, Daniel D, Vicente D, Murakami S, Hui R, et al. Overall survival with durvalumab after chemoradiotherapy in stage III NSCLC. N Engl J Med 2018;379:2342-2350
  9. Burris HA 3rd, Hurtig J. Radiation recall with anticancer agents. Oncologist 2010;15:1227-1237
  10. Ding X, Ji W, Li J, Zhang X, Wang L. Radiation recall pneumonitis induced by chemotherapy after thoracic radiotherapy for lung cancer. Radiat Oncol 2011;6:24
  11. Azria D, Magne N, Zouhair A, Castadot P, Culine S, Ychou M, et al. Radiation recall: a well recognized but neglected phenomenon. Cancer Treat Rev 2005;31:555-570
  12. Schwarte S, Wagner K, Karstens JH, Bremer M. Radiation recall pneumonitis induced by gemcitabine. Strahlenther Onkol 2007;183:215-217
  13. Hill AB, Tattersall SF. Recall of radiation pneumonitis after intrapleural administration of doxorubicin. Med J Aust 1983;1:39-40
  14. Mclnerney DP, Bullimore J. Reactivation of radiation pneumonitis by adriamycin. Br J Radiol 1977;50:224-227
  15. Chan RT, Au GK, Ho JW, Chu KW. Radiation recall with oxaliplatin: report of a case and a review of the literature. Clin Oncol (R Coll Radiol) 2001;13:55-57
  16. Togashi Y, Masago K, Mishima M, Fukudo M, Inui K. A case of radiation recall pneumonitis induced by erlotinib, which can be related to high plasma concentration. J Thorac Oncol 2010;5:924-925
  17. Clark D, Gauchan D, Ramaekers R, Norvell M, Copur MS. Radiation recall pneumonitis during systemic treatment with everolimus. Oncol Res 2014;22:321-324
  18. Yuasa T, Kitsukawa S, Sukegawa G, Yamamoto S, Kudo K, Miyazawa K, et al. Early onset recall pneumonitis during targeted therapy with sunitinib. BMC Cancer 2013;13:3
  19. Thore P, Godbert B, Petit I, Chaouat A. Radiation recall pneumonitis in a patient treated by nivolumab for non-small-cell lung cancer, no relapse with rechallenge. J Med Oncol 2018;1:12
  20. Shinada K, Murakami S, Yoshida D, Saito H. Radiation recall pneumonitis after COVID-19 vaccination. Thorac Cancer 2022;13:144-145
  21. Hughes NM, Hammer MM, Awad MM, Jacene HA. Radiation recall pneumonitis on FDG PET/CT triggered by COVID-19 vaccination. Clin Nucl Med 2022;47:e281-e283
  22. Cousin F, Desir C, Ben Mustapha S, Mievis C, Coucke P, Hustinx R. Incidence, risk factors, and CT characteristics of radiation recall pneumonitis induced by immune checkpoint inhibitor in lung cancer. Radiother Oncol 2021;157:47-55
  23. Jan PR, Chang JW, Wu CE. Radiation recall pneumonitis: a rare syndrome that should be recognized. Cancers (Basel) 2022;14:4642
  24. Chiang CL, Chen YW, Wu MH, Huang HC, Tsai CM, Chiu CH. Radiation recall pneumonitis induced by epidermal growth factor receptor-tyrosine kinase inhibitor in patients with advanced nonsmall-cell lung cancer. J Chin Med Assoc 2016;79:248-255
  25. Strange CD, Shroff GS, Truong MT, Nguyen QN, Vlahos I, Erasmus JJ. Imaging of the post-radiation chest in lung cancer. Clin Radiol 2022;77:19-30
  26. Shroff GS, Strange CD, Altan M, Carter BW, Ahuja J, Godoy MCB, et al. Post-immunotherapy imaging in lung cancer. Clin Radiol 2022;77:44-57
  27. Berthod G, Lazor R, Letovanec I, Romano E, Noirez L, Mazza Stalder J, et al. Pulmonary sarcoid-like granulomatosis induced by ipilimumab. J Clin Oncol 2012;30:e156-e159
  28. Montaudie H, Pradelli J, Passeron T, Lacour JP, Leroy S. Pulmonary sarcoid-like granulomatosis induced by nivolumab. Br J Dermatol 2017;176:1060-1063
  29. Cousin S, Italiano A. Pulmonary sarcoidosis or post-immunotherapy granulomatous reaction induced by the anti-PD-1 monoclonal antibody pembrolizumab: the terminology is not the key point. Ann Oncol 2016;27:1974-1975
  30. Tetzlaff MT, Nelson KC, Diab A, Staerkel GA, Nagarajan P, Torres-Cabala CA, et al. Granulomatous/sarcoid-like lesions associated with checkpoint inhibitors: a marker of therapy response in a subset of melanoma patients. J Immunother Cancer 2018;6:14
  31. Gkiozos I, Kopitopoulou A, Kalkanis A, Vamvakaris IN, Judson MA, Syrigos KN. Sarcoidosis-like reactions induced by checkpoint inhibitors. J Thorac Oncol 2018;13:1076-1082
  32. Rapoport BL, Shannon VR, Cooksley T, Johnson DB, Anderson L, Blidner AG, et al. Pulmonary toxicities associated with the use of immune checkpoint inhibitors: an update from the immuno-oncology subgroup of the neutropenia, infection & myelosuppression study group of the multinational association for supportive care in cancer. Front Pharmacol 2021;12:743582
  33. Schneider BJ, Naidoo J, Santomasso BD, Lacchetti C, Adkins S, Anadkat M, et al. Management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy: ASCO guideline update. J Clin Oncol 2021;39:4073-4126
  34. Strange TA, Erasmus LT, Ahuja J, Agrawal R, Shroff GS, Truong MT, et al. Spectrum of imaging patterns of lung cancer following radiation therapy. Diagnostics (Basel) 2023;13:3283