Prophylactic Effect of Clarithromycin on Radiation Pneumonitis in IMRT for Lung Cancer

• Published in: Anticancer research Vol. 44; no. 7; pp. 2989 - 2995
• Main Authors: Ohguri, Takayuki, Morisaki, Takahiro, Itamura, Hirohide, Tani, Subaru, Yatera, Kazuhiro, Tanaka, Fumihiro
• Format: Journal Article
• Language: English
• Published: Greece International Institute of Anticancer Research 01.07.2024
• Subjects: Adult; Aged; Aged, 80 and over; Clarithromycin; Clarithromycin - therapeutic use; Clinical trials; Female; Humans; Lung cancer; Lung Neoplasms - pathology; Lung Neoplasms - radiotherapy; Male; Middle Aged; Pneumonitis; Radiation; Radiation Pneumonitis - etiology; Radiation Pneumonitis - prevention & control; Radiation therapy; Radiotherapy, Intensity-Modulated - adverse effects; Radiotherapy, Intensity-Modulated - methods; Retrospective Studies; lung cancer; clarithromycin; Radiation pneumonitis; intensity modulated radiation therapy
• ISSN: 0250-7005; 1791-7530; 1791-7530
• DOI: 10.21873/anticanres.17111

To evaluate the association between prophylactic administration of clarithromycin (CAM) and the development of radiation pneumonitis (RP) in patients treated with intensity modulated radiation therapy (IMRT) for lung cancer. A total of 89 patients who underwent definitive or salvage IMRT for lung cancer were retrospectively evaluated. The median total and daily doses were 60 Gy and 2 Gy, respectively. A total of 39 patients (44%) received CAM for a median of three months after the start of IMRT. The relationship between the development of RP and certain clinical factors was analyzed. RP of Grade ≥2 was recognized in 10 (11%) patients; Grade 2 in six patients and Grade 3 in four patients. The incidence of Grade ≥2 RP was 3% (1/39) in patients treated with CAM, which was significantly lower than that of 18% (9/50) in patients without CAM. The median lung V20 and V5 in the 10 patients with RP Grade ≥2 were 24% and 46%, respectively, compared with 18% and 37% in the 79 patients with RP Grade 0-1, and the differences were significant. Durvalumab administration after IMRT was also a significant factor for RP Grade ≥2. Prophylactic administration of CAM may reduce Grade ≥2 RP in patients treated with IMRT for lung cancer. Therefore, further clinical trials are warranted.