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Publications

English Abstract Journal Article Review Ahead of print

PubMed: 40774102 DOI: 10.1016/j.canrad.2025.104687

[Recommendations on the prevention and management of radiation-induced lung injury from the Association francophone pour les soins oncologiques de support and the Société française de radiothérapie oncologique].

Cancer Radiother 29(5-6):104687

Authors: Olivier Cravéreau, Vincent Bourbonne, Loïg Vaugier, François Lucia, Florence Le Tinier, Jacques Cadranel, Boris Duchemann, Paul Habert, Nicolas Martz, William Gehin, Marie Bruand, Anaïs Stefani, Johann Marcel, Ida Trampetti, Christelle Clément-Duchêne, Delphine Lerouge, Adrien Laville, Kim Cao, Nicolas Pourel, Audrey Zaccariotto, Aurélie Bellière-Calendry, François Thillays, Ronan Tanguy, Delphine Antoni, Nicolas Girard, Étienne Martin, Benoît Godbert, Assaad Nakad, Gautier Treffel, Michaël Massin, Vivien Charzat, Sébastien Thureau, Ariane Lapierre, Jean-Christophe Faivre

Affiliations

  • Department of Radiation Oncology, Institut de cancérologie de Lorraine, Vandœuvre-lès-Nancy, France.
  • Radiation Oncology Department, CHU de Brest, Brest, France; LaTim, Inserm, UMR 1101, université de Bretagne Occidentale, Brest, France.
  • Department of Radiation Oncology, Institut de cancérologie de l'Ouest, Saint-Herblain, France.
  • Academic Department of Radiation Oncology and Brachytherapy, centre Oscar-Lambret, Lille, France.
  • Department of Pneumology, hôpital Tenon, Institut universitaire de cancérologie, Sorbonne Université, AP-HP, Paris, France.
  • Medical Oncology Department, hôpital Avicenne, Bobigny, France.
  • Department of Radiology, Aix-Marseille Université, Assistance Publique-Hôpitaux de Marseille, Marseille, France.
  • Department of Radiation Oncology, Institut de cancérologie de Lorraine, Vandœuvre-lès-Nancy, France.
  • Oncology Department, Institut de cancérologie de Lorraine, Vandœuvre-lès-Nancy, France.
  • Radiotherapy Department, centre François-Baclesse, Caen, France.
  • Radiation Oncology Department, centre hospitalier universitaire d'Amiens-Picardie, 30, avenue de la Croix-Jourdain, 80054 Amiens, France.
  • Department of Radiation Oncology, institut Curie, Paris, France.
  • Radiation Oncology, institut Sainte-Catherine, Avignon, France.
  • Department of Radiation Oncology, Assistance publique-hôpitaux de Marseille, Marseille, France.
  • Department of Radiotherapy, centre Jean-Perrin, Clermont-Ferrand, France.
  • Department of Radiotherapy, centre Léon-Bérard, Lyon, France.
  • Department of Radiotherapy, ICANS, Institut de cancérologie de Strasbourg, Strasbourg, France.
  • Institut du thorax Curie-Montsouris, institut Curie, Paris, France; Paris-Saclay Campus, université de Versailles-Saint-Quentin, Versailles, France.
  • Department of Radiotherapy, centre Georges-François-Leclerc, Dijon, France.
  • Department of Pneumology, hôpital privé de Metz, Metz, France.
  • Department of Pulmonology, centre hospitalier Bar-le-Duc-Fains-Véel, Bar-le-Duc, France.
  • Department of Pulmonology, centre hospitalier universitaire de Nancy, Nancy, France.
  • Department of Cardiology, centre hospitalier universitaire de Nancy, Nancy, France.
  • Agence COMM Santé, Talence, France.
  • Department of Radiation Oncology and Nuclear Medicine, centre Henri-Becquerel, QuantIF Litis, Rouen, France.
  • Department of Radiotherapy-Oncology, hôpital Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France.

Abstract

PURPOSE

Radiation-induced lung injury is relatively uncommon but disabling, and a dose-limiting factor in thoracic radiotherapy. This complication is mainly encountered following radiotherapy for lung cancers. We provide recommendations for good clinical practice, defining the prevention and management of radiation-induced lung injury.

METHODS

Members of the Association francophone pour les soins oncologiques de support (Afsos; French-speaking association for oncology care and support) and the Société française de radiothérapie oncologique (SFRO, French society for radiation oncology) set up a multidisciplinary working and review group to draft these recommendations for 2023 to 2024, based on a systematic review of the literature.

RESULTS

Radiation-induced lung injury comprises several forms, mainly resulting from acute toxicity (radiation pneumonitis) and chronic toxicity (radiation fibrosis). Specific forms can be identified, such as organising pneumonia (formerly bronchiolitis obliterans organizing pneumonia) and radiation recall pneumonia. The risk factors are numerous and include dosimetric risk factors, patient-related factors and tumour-related factors. New challenges include the specific complications of stereotactic radiotherapy, the combination of recent specific oncological treatments including tyrosine kinase inhibitors and immunotherapy, and the association with certain pathologies such as interstitial lung disease.

CONCLUSION

The profile of radiation-induced lung injury is evolving with new radiotherapy techniques and innovative systemic oncology treatments. Rapid detection and management of these side-effects are essential for good patient care.

MeSH

Radiotherapy, Lung, Lung Injury, Pneumonia, Risk Factors, Therapeutics