Case Report: Grade 4 pneumonitis occurred after thoracic radiotherapy and dacomitinib in a patient with lung adenocarcinoma
Osimertinib combined with chest radiotherapy has a high incidence of pneumonia, dacomitinib is widely used in clinical practice, but there are no studies reporting the pulmonary safety of dacomitinib in combinating with radiotherapy. Here we report a case of radiation pneumonitis occurring by dacomi...
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Frontiers Media S.A.
2025-02-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1436134/full |
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| author | Ailing Liu Junxu Wen Kaikai Zhao Liyang Jiang Xiangjiao Meng |
| author_facet | Ailing Liu Junxu Wen Kaikai Zhao Liyang Jiang Xiangjiao Meng |
| author_sort | Ailing Liu |
| collection | DOAJ |
| description | Osimertinib combined with chest radiotherapy has a high incidence of pneumonia, dacomitinib is widely used in clinical practice, but there are no studies reporting the pulmonary safety of dacomitinib in combinating with radiotherapy. Here we report a case of radiation pneumonitis occurring by dacomitinib and thoracic radiotherapy (TRT). The patient was a 55-year-old woman with lung adenocarcinoma. She had received surgery and adjuvant chemotherapy. The patient presented with bilateral intramammary and para-aortic metastatic lymphadenopathy, which was confirmed as metastasis, and subsequently received treatment with dacomitinib. Radiotherapy started after 4 months of dacomitinib. The Clinical Target Volume (CTV) was metastatic lymph nodes area. The prescription dose was 60 Gy/30F. The mean lung dose (MLD), V20, and V5 were 8.16Gy, 16%, and 34.5%. Despite the lung V20 and mean lung dose being exceptionally low, the patient exhibited respiratory symptoms, and a CT chest scan revealed grade 4 radiation pneumonitis two weeks following the conclusion of radiotherapy. The radiotherapy and dacomitinib were discontinued, and immediate initiation of pulmonary anti-inflammatory treatment ensued. The concurrent administration of dacomitinib and RT carries the risk of inducing serious pneumonia. This case highlights the potential risk of severe pneumonia associated with this combination therapy, emphasizing the need for further research to clarify its safety and develop effective management strategies. |
| format | Article |
| id | doaj-art-36d58436b0ef4aa08594408ffdda756c |
| institution | OA Journals |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj-art-36d58436b0ef4aa08594408ffdda756c2025-08-20T02:15:51ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-02-011510.3389/fonc.2025.14361341436134Case Report: Grade 4 pneumonitis occurred after thoracic radiotherapy and dacomitinib in a patient with lung adenocarcinomaAiling Liu0Junxu Wen1Kaikai Zhao2Liyang Jiang3Xiangjiao Meng4School of Clinical Medicine, Shandong Second Medical University, Weifang, ChinaDepartment of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, ChinaDepartment of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, ChinaDepartment of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, ChinaDepartment of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, ChinaOsimertinib combined with chest radiotherapy has a high incidence of pneumonia, dacomitinib is widely used in clinical practice, but there are no studies reporting the pulmonary safety of dacomitinib in combinating with radiotherapy. Here we report a case of radiation pneumonitis occurring by dacomitinib and thoracic radiotherapy (TRT). The patient was a 55-year-old woman with lung adenocarcinoma. She had received surgery and adjuvant chemotherapy. The patient presented with bilateral intramammary and para-aortic metastatic lymphadenopathy, which was confirmed as metastasis, and subsequently received treatment with dacomitinib. Radiotherapy started after 4 months of dacomitinib. The Clinical Target Volume (CTV) was metastatic lymph nodes area. The prescription dose was 60 Gy/30F. The mean lung dose (MLD), V20, and V5 were 8.16Gy, 16%, and 34.5%. Despite the lung V20 and mean lung dose being exceptionally low, the patient exhibited respiratory symptoms, and a CT chest scan revealed grade 4 radiation pneumonitis two weeks following the conclusion of radiotherapy. The radiotherapy and dacomitinib were discontinued, and immediate initiation of pulmonary anti-inflammatory treatment ensued. The concurrent administration of dacomitinib and RT carries the risk of inducing serious pneumonia. This case highlights the potential risk of severe pneumonia associated with this combination therapy, emphasizing the need for further research to clarify its safety and develop effective management strategies.https://www.frontiersin.org/articles/10.3389/fonc.2025.1436134/fullnon-small cell lung cancer (NSCLC)EGFR mutationdacomitinibthoracic radiotherapyradiation pneumonia |
| spellingShingle | Ailing Liu Junxu Wen Kaikai Zhao Liyang Jiang Xiangjiao Meng Case Report: Grade 4 pneumonitis occurred after thoracic radiotherapy and dacomitinib in a patient with lung adenocarcinoma Frontiers in Oncology non-small cell lung cancer (NSCLC) EGFR mutation dacomitinib thoracic radiotherapy radiation pneumonia |
| title | Case Report: Grade 4 pneumonitis occurred after thoracic radiotherapy and dacomitinib in a patient with lung adenocarcinoma |
| title_full | Case Report: Grade 4 pneumonitis occurred after thoracic radiotherapy and dacomitinib in a patient with lung adenocarcinoma |
| title_fullStr | Case Report: Grade 4 pneumonitis occurred after thoracic radiotherapy and dacomitinib in a patient with lung adenocarcinoma |
| title_full_unstemmed | Case Report: Grade 4 pneumonitis occurred after thoracic radiotherapy and dacomitinib in a patient with lung adenocarcinoma |
| title_short | Case Report: Grade 4 pneumonitis occurred after thoracic radiotherapy and dacomitinib in a patient with lung adenocarcinoma |
| title_sort | case report grade 4 pneumonitis occurred after thoracic radiotherapy and dacomitinib in a patient with lung adenocarcinoma |
| topic | non-small cell lung cancer (NSCLC) EGFR mutation dacomitinib thoracic radiotherapy radiation pneumonia |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1436134/full |
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