DOI: 10.57760/sciencedb.zhfsyxyfhzz.00029
title: Chinese Expert Consensus on Interstitial Pneumonia Induced by Thoracic Radiotherapy Combined with Immune Checkpoint Inhibitors
title: 胸部放疗联合免疫检查点抑制剂所致间质性肺炎的中国专家共识

description: Thoracic radiotherapy (TRT) combined with immune checkpoint inhibitors (ICIs) can induce interstitial lung disease (ILD), for which standardized diagnostic and therapeutic protocols are currently lacking. A multidisciplinary expert panel has developed this consensus based on the latest evidence to standardize ILD management and enhance treatment safety. The consensus outlines the following key points: (1) Radiation pneumonitis (RP), resulting from radiotherapy injury, and checkpoint inhibitor pneumonitis (CIP), driven by immune hyperactivation, exhibit complex pathogenesis with distinct imaging features, yet share non-specific manifestations; (2) Corticosteroids are foundational for graded treatment and dynamic management; (3) Management of TRT-ICIs-associated ILD requires precise guidance under multidisciplinary treatment (MDT); (4) Pre-existing lung diseases are significant risk factors for ILD; (5) Close monitoring and individualized adjustments are crucial for steroid-resistant populations; (6) Treatment rechallenge strategies should be tailored to individual patient conditions; (7) Combined therapy for various thoracic tumors necessitates careful risk assessment; (8) Novel detection technologies and artificial intelligence represent promising future directions. This consensus provides a comprehensive framework for the full-cycle management of TRT-ICIs-induced ILD, facilitating early detection, precise intervention, reduced treatment-related toxicity, and improved quality of life for patients with thoracic malignancies.
description: Thoracic radiotherapy (TRT) combined with immune checkpoint inhibitors (ICIs) can induce interstitial lung disease (ILD), for which standardized diagnostic and therapeutic protocols are currently lacking. A multidisciplinary expert panel has developed this consensus based on the latest evidence to standardize ILD management and enhance treatment safety. The consensus outlines the following key points: (1) Radiation pneumonitis (RP), resulting from radiotherapy injury, and checkpoint inhibitor pneumonitis (CIP), driven by immune hyperactivation, exhibit complex pathogenesis with distinct imaging features, yet share non-specific manifestations; (2) Corticosteroids are foundational for graded treatment and dynamic management; (3) Management of TRT-ICIs-associated ILD requires precise guidance under multidisciplinary treatment (MDT); (4) Pre-existing lung diseases are significant risk factors for ILD; (5) Close monitoring and individualized adjustments are crucial for steroid-resistant populations; (6) Treatment rechallenge strategies should be tailored to individual patient conditions; (7) Combined therapy for various thoracic tumors necessitates careful risk assessment; (8) Novel detection technologies and artificial intelligence represent promising future directions. This consensus provides a comprehensive framework for the full-cycle management of TRT-ICIs-induced ILD, facilitating early detection, precise intervention, reduced treatment-related toxicity, and improved quality of life for patients with thoracic malignancies.