ESMO 2024: Can Adding Corticosteroid to Radiotherapy for NSCLC Reduce Pneumonitis?

By: Justine Landin, PhD
Posted: Tuesday, September 17, 2024

The addition of a corticosteroid to thoracic radiotherapy may reduce the incidence of radiation-induced pneumonitis in patients with non–small cell lung cancer (NSCLC), according to Jie Zhang, PhD, of Shanghai Pulmonary Hospital, China, and colleagues. In fact, inhaled beclomethasone propionate lowered the likelihood of developing grade 3 or greater radiation pneumonitis in this patient population. The findings of this randomized, open-label phase II study were presented at the European Society for Medical Oncology (ESMO) Congress 2024 (Abstract 1242MO).

“Radiation-induced lung injury is a serious long-term complication of radiotherapy with limited treatment option[s],” stated the investigators. “The addition of inhaled corticosteroids to radiotherapy significantly reduced the incidence of radiation-induced pneumonitis in patients with NSCLC.”

Eligible patients with locally advanced, nonmetastatic NSCLC were enrolled from 2019 to 2021 at Shanghai Pulmonary Hospital (n = 292). Patients were randomly assigned to receive either beclomethasone propionate concurrently with radiotherapy (n = 142) or radiotherapy alone (n = 150). Both patient groups received treatment once daily. Any supplementary treatments were administered according to the standard of care and at the treating physician’s discretion.  

The incidence of all-grade radiation pneumonitis was lower in the corticosteroid group (35.3%) compared with the radiotherapy-alone group (52.8%, P = .03). The objective response rates of the patients in the corticosteroid group and radiotherapy-alone group were 40.9% and 35.9%, respectively (P = .65). At a follow-up of 2 years, no difference was observed in overall survival (P = .43) between the groups. Fewer patients given the corticosteroid experienced grade 3 or greater radiation pneumonitis (12%) compared with those who received radiotherapy alone (28.2%, P = .01).

Disclosure: The study authors reported no conflicts of interest.

ESMO Congress 2024

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