| Chinese Society of Clinical Oncology (CSCO) Committee on Immunotherapy,Chinese Medical Association Digital Medicine Branch,Chongqing Association for Integrative Medicine Committee on Cancer Immunotherapy,et al.Expert consensus on diagnosis and treatment of interstitial pneumonia induced by thoracic radiotherapy combined with immune checkpoint inhibitors (2026 version)[J].Chinese Journal of Radiological Medicine and Protection,2026,46(3):213-229 |
| Expert consensus on diagnosis and treatment of interstitial pneumonia induced by thoracic radiotherapy combined with immune checkpoint inhibitors (2026 version) |
| Received:August 13, 2025 |
| DOI：10.3760/cma.j.cn112271-20250813-00295 |
| KeyWords:Thoracic radiotherapy (TRT) Immune checkpoint inhibitor (ICI) Interstitial lung disease (ILD) Multidisciplinary treatment (MDT) Expert consensus |
| FundProject:国家四大慢病重大专项(2023ZD0502100);重庆市科卫联合医学科研项目(2023DBXM002);重庆市技术创新与应用发展项目(CSTB2022TIAD-KPX0176);重庆市医学领军人才项目(YXLJ202405) |
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| Abstract:: |
| 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: 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. Corticosteroids are foundational for graded treatment and dynamic management. Management of TRT-ICIs-associated ILD requires precise guidance under multidisciplinary treatment (MDT). Pre-existing lung diseases are significant risk factors for ILD. Close monitoring and individualized adjustments are crucial for steroid-resistant populations. Treatment rechallenge strategies should be tailored to individual patient conditions. Combined therapy for various thoracic tumors necessitates careful risk assessment. Novel detection technologies and artificial intelligence (AI) represent future research directions. This consensus provides a comprehensive framework for the whole-process management of ILD induced by TRT combined with ICIs. It will help conduct early detection and precise intervention, reduce treatment-related adverse reactions, and improve the quality of life of patients with thoracic tumors. |
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