{
  "abstract": "Objective: This study aimed to relieve radiation-induced lung injury (RILI) by assessing the use of prophylactic pirfenidone. Subjects were lung cancer patients with prior ICI treatment who received thoracic radiotherapy.\n\nMethods: Patients with lung cancer were enrolled in this phase II single-arm study. All candidates had a history of prior ICI exposure (≥2 cycles; interval ≤6 months) scheduled for thoracic radiotherapy (≥50 Gy). Patients received oral pirfenidone (1800 mg/day) from one week pre-radiotherapy to four weeks post-completion. The primary endpoint was the 6-month incidence of ≥grade 2 RILI, compared to a 40% historical control (p ₀ =0.40; p ₁ =0.22; α=0.10; power=80%). Secondary endpoints included pulmonary function (DLCO%, FVC%) and safety.\n\nResults: A total of 39 patients were enrolled in this trial. At the 6-month follow-up, the incidence of grade 2 or higher RILI was 23.1% (9/39; 95% CI: 11.1%–39.3%). This rate was statistically significantly lower than the 40% incidence from the historical control cohort (p=0.0205). Grade 3 RILI occurred in 7.7% (3/39); no grade 4–5 events occurred. Mean DLCO% declined by 7.6 ± 5.4% at 3 months and 6.5 ± 5.8% at 6 months. The pirfenidone completion rate was 84.6% (median relative dose intensity: 89.3%). Common adverse events were fatigue (43.6%), nausea (41.0%), and appetite loss (33.3%), mostly grade 1–2.\n\nConclusions: Preventive use of pirfenidone was associated with a lower observed incidence and severity of RILI than the predefined historical control in ICI-pretreated lung cancer patients receiving thoracic radiotherapy. Additionally, the intervention showed a potential protective trend for pulmonary diffusion function. These findings require further validation in a phase III trial.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Radiation Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology",
    "Department of Oncology, Jianghan Oilfield General Hospital"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yujie Huang"
    },
    {
      "affs": [
        0
      ],
      "name": "Jia Ma"
    },
    {
      "affs": [
        0
      ],
      "name": "Guang Han"
    },
    {
      "affs": [
        0
      ],
      "name": "JianPing Bi"
    },
    {
      "affs": [
        0
      ],
      "name": "Guoliang Pi"
    },
    {
      "affs": [
        0
      ],
      "name": "Ying Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Yi Peng"
    },
    {
      "affs": [
        0
      ],
      "name": "Chuangying Xiao"
    },
    {
      "affs": [
        1
      ],
      "name": "Xiulin Tuo"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9e3j2ch54vgta.bib",
  "cited_by": 0,
  "doi": "10.3389/fonc.2026.1876642",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13716608/?tool=EBI",
  "id": "9e3j2ch54vgta",
  "issns": [
    "2234-943X"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1876642/full",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2741|Effects of Radiation Exposure"
    ]
  ],
  "openalex": "W7222285748",
  "pdf_url": "https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2026.1876642/pdf",
  "pmcid": "PMC13716608",
  "pmid": "42959154",
  "published": "2026-10-15",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/9e3j2ch54vgta.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:13Z",
      "native_id": "10.3389/fonc.2026.1876642",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1876642/full"
    },
    {
      "first_seen": "2026-10-31T00:20:37Z",
      "native_id": "PMC:PMC13716608",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13716608"
    },
    {
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      "native_id": "MED:42959154",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42959154"
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    {
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      "native_id": "PMC13716608",
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      "url": "https://doi.org/10.3389/fonc.2026.1876642"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2741|Effects of Radiation Exposure",
      "subfield": "imaging"
    }
  ],
  "title": "Prophylactic pirfenidone to prevent radiation- induced lung injury in ICI-pretreated lung cancer patients: a phase II study",
  "title_text": "Prophylactic pirfenidone to prevent radiation- induced lung injury in ICI-pretreated lung cancer patients: a phase II study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-02T12:21:06Z",
  "url": "https://research.draconitic.com/paper/9e3j2ch54vgta",
  "venue": "Frontiers in Oncology",
  "versions": []
}