Comparison of clinical and CT features between mild-moderate and severe PD-1/PD-L1 immune checkpoint inhibitor associat-ed pneumonia
Objective To compare the clinical and CT features between mild-moderate and severe programm-ed death-1(PD-1)/programmed death-ligand 1(PD-L1)immune checkpoint inhibitor associated pneumonia.Methods Twenty-one patients who received PD-1/PD-L1 ICI treatment in Zhejiang Cancer Hospital from September 2018 to September 2021 and developed ICI associated pneumonia were selected as the study objects.They were divided into mild-moderate group(n=14)and severe group(n=7)according to the adverse event assessment criteria 5.0 released by the US Department of Health and Human Services.The clinical characteristics(mainly including the time from ICI treatment to the onset of pneumonia,pathological type of the primary lesion,radiation history,immunotherapies,clinical symptoms and so on)and CT features(mainly including CT classification,lesion density,lesion location,presence of pleural effusion and so on)between two groups of patients were compared.Results Comparison of clinical characteristics showed that the proportions of women and asymptomatic patients,and BMI in the mild-to-moderate group were significantly higher than those in the severe group(all P＜0.05).There were no statistically significant differences between the two groups in age,time from ICI treatment to pneumonia occurrence,smoking history,classification of primary lesion,pathological type of primary lesion,radiotherapy history,type of ICI,immunotherapies,number of lines of immunotherapy,chest tightness and shortness of breath,cough with sputum,fever,respiratory failure,et al(all P＞0.05).The proportions of OP type of CT classification,peripheral pulmonary lesions,non-symmetrical lesions in both lungs in mild-moderate group were significantly higher than those of the severe group(all P＜0.05).No statistical significant differences were found in lesion density,lobular septal thickening,lesion distribution and pleural effusion between the two groups(all P＞0.05).Conclusion There are significant differences in clinical features and CT imaging findings between patients with mild-moderate and severe PD-1/PD-L1 ICI associated pneumonia.
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