S843
Clinical - Lung
ESTRO 2026
pulmonary fibrosis (35%) was the most frequent ILD subtype, 46% of patients with other ILD subtypes had a progressive pulmonary fibrosis (PPF) phenotype. Our ILD team, recommended concurrent on/off-label antifibrotic therapy in 28%/7% of patients, 33% received immunosuppressive therapy. In total, 48 patients (40%) were treated with radiotherapy and 49 (41%) with surgery. Thirteen patients (27%) developed radiation pneumonitis (grade 2, n=8; grade 3, n=3; grade 5, n=2), and eight (16%) had surgical complications (grade 2, n=1; grade 3, n=1; grade 4, n=4; grade 5, n=2). Thirteen patients (11%) experienced an acute ILD exacerbation, resulting in death in three cases (2%).
Longtumoren. Utrecht: NVRO; 2019.4. Langendijk JA, et al. Selection of patients for
radiotherapy with protons aiming at reduction of side effects: The model-based approach. Radiotherapy and Oncology. 2013;107(3):267-73. Keywords: proton therapy, stage III NSCLC, radiation toxicity Digital Poster Highlight 4382 Impact of combined ILD and lung cancer multidisciplinary team assessment on treatment selection and toxicity. Mathijs Tomassen 1 , Suzan Nijman 2 , Esther Nossent 2 , Iris Simons 2 , Chris Dickhoff 3 , Onno Mets 4 , Teodora Radonic 5 , Bart Boerrigter 2 , Martijn van Dorp 3 , David Heineman 3 , Idris Bahce 2 , Max Dahele 1 , Femke Spoelstra 1 , Patricia de Haan 1 , Joost Verhoeff 1 , Peter van Rossum 1 , Suresh Senan 1 1 Radiation Oncology, Amsterdam UMC, Amsterdam, Netherlands. 2 Pulmonary Medicine, Amsterdam UMC, Amsterdam, Netherlands. 3 Cardiothoracic Surgery, Amsterdam UMC, Amsterdam, Netherlands. 4 Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam, Netherlands. 5 Pathology, Amsterdam UMC, Amsterdam, Netherlands Purpose/Objective: Patients presenting with both interstitial lung disease (ILD) and lung cancer represent a population at higher risk for treatment complications and a poorer overall survival. Published rates of grade 5 radiation pneumonitis are as high as 21% (1), with all grade of acute exacerbation ILD after surgical intervention ranging from 9% to 23% (2).This study evaluated the single academic institutional outcomes of a structured ILD evaluation by experts accompanying the case review by a multidisciplinary lung tumor board (MDT). Material/Methods: This retrospective study included patients with ILD and lung cancer who were either referred to or diagnosed at our hospital in 2006-2024. Patients underwent combined review by a specialized multidisciplinary ILD team in addition to a thoracic oncology MDT. Changes in ILD subtype classification, type of treatment and treatment-related toxicities were systematically assessed. Results: A total of 121 patients with ILD and lung cancer were evaluated. Median age was 71 years (IQR 65–77), and 70% were male. Stage I disease was present in 44%, stage II in 20%, stage III in 28%, and stage IV in 8% (Figure 1). Most patients (n=107, 89%) were referred from other centers. The ILD subtype classification made by our team differed from that made in the referring center in 74% of cases (Figure 2). Idiopathic
Conclusion: Following implementation of a structured institutional program, the ILD subtype classification was frequently (74%) revised after evaluation by a specialized ILD team. The incidence of high-grade adverse events compared favorably with previous reports, highlighting the importance of the combination of expert ILD and thoracic oncology review. References: 1. Frank AJ, Dagogo-Jack I, Dobre IA, Tait S, Schumacher L, Fintelmann FJ, et al. Management of Lung Cancer in the Patient with Interstitial Lung Disease. The Oncologist. 2023;28(1):12-222. Kobayashi, H., Naito, T., Omae, K., Omori, S., Nakashima, K., Wakuda, K., Ono, A., Kenmotsu, H., Murakami, H., Endo, M., Harada, H., Takahashi, T.
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