ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG Ở BỆNH NHÂN VIÊM PHỔI LIÊN QUAN THUỐC ỨC CHẾ ĐIỂM KIỂM SOÁT MIỄN DỊCH

Abstract

Objectives: This study aimed to identify key clinical and subclinical characteristics of immune checkpoint inhibitor-related pneumonitis (ICI-P). Subjects and methods: We conducted a retrospective, cross-sectional study involving 10 patients diagnosed with ICI-P among 61 patients treated with ICI at Oncology-Hematology Department, Vinmec Times City international hospital in 2023. Results: ICI-P was identified in 10 patients in total of 61 patients (16%). The average age is 69 years old. 40% of patients have a history of lung disease and a history of thoracic radiation therapy. Average onset time after using 4.7 cycles of ICI medication. The most common clinical symptoms are cough, fever, and difficulty breathing. Ground-glass opacities was found in almost all cases (accounted for 90%), followed by consolidation lesions. There were 3 patients with grade 4 pneumonitis and no deaths (grade 5). On average, corticosteroid dose was 50 mg/kg prednisolone in grade 2 group and treatment duration was 5.4 weeks. In grade 3-4 group, the dose of corticosteroid was higher (75mg/kg prednisolone) and treatment duration was longer (7.2 weeks). Conclusions: ICI-pneumonitis is a serious complication, non-specific clinical symptoms, and requires long treatment duration. It is a challenge for clinicians requiring comprehensive skills to manage it.