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Review
. 2019 Apr 10;5(5):FSO378.
doi: 10.2144/fsoa-2018-0123. eCollection 2019 Jun.

Radiation recall pneumonitis in the setting of immunotherapy and radiation: a focused review

Kerri McGovern  1   1 , Maged Ghaly  2   2 , Michael Esposito  3   3 , Keara Barnaby  1   1 , Nagashree Seetharamu  1   1
Affiliations
Review

Radiation recall pneumonitis in the setting of immunotherapy and radiation: a focused review

Kerri McGovern et al. Future Sci OA. .

Abstract

Radiation recall pneumonitis (RRP) is an entity described as pneumonitis localized to a previously irradiated field after exposure to a systemic agent. It has previously been described in the literature in the context of chemotherapeutic agents as well as certain biologics. With immunotherapy taking a more prominent role in the treatment of several different malignancies and its own baseline risk of pneumonitis, it is important to explore the likelihood of RRP, specifically in those patients who have been previously treated with radiation therapy. The current literature regarding RRP with checkpoint inhibitors is reviewed in this article. Alongside this review, we report a case of RRP after pembrolizumab initiation in a patient in our practice.

Keywords: checkpoint inhibitors; immunotherapy; pneumonitis; radiation recall pneumonitis; thoracic radiation.

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Conflict of interest statement

Financial & competing interests disclosure The authors have no relevant affiliations or financialinvolvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. No writing assistance was utilized in the production of this manuscript.

Figures

<b>Figure 1.</b>
Figure 1.. Top image shows initial right upper lobe dense infiltrate suggestive of radiation pneumonitis and bottom image shows resolution of infiltrate 3 months after initiation of prednisone.
<b>Figure 2.</b>
Figure 2.. Prior right lateral chest wall mass radiation dosimetry (right) and radiation field overlying the PET/CT scan visualizing the radiation recall pneumonitis (left).
<b>Figure 3.</b>
Figure 3.. Chronic inflammation and Type 2 pneumocyte hyperplasia as seen on endobronchial biopsy.
See this image and copyright information in PMC

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