Can pirfenidone and nintedanib be alternative treatment options for radiation pneumonitis?

Abstract

Radiation-induced pneumonitis (RP) is an early event observed in most patients exposed to radiation, typically occurring within 2-4 months after treatment and potentially leading to fibrosis1 . While clinical observation is recommended for mild symptoms of radiation pneumonitis, systemic steroid therapy is advised for symptomatic patients, provided that lung infection is excluded2 . In cases where there is no response to systemic steroid therapy, treatments such as azathioprine, cyclosporine, amifostine, and pentoxifylline can be attempted. We achieved near-complete improvement in symptoms, high-resolution computed tomography (HRCT) images, and pulmonary function test parameters, in two patients who developed radiation pneumonitis following radiotherapy (RT) for breast cancer and lung cancer by administering nintedanib and pirfenidone treatments.