How do you prescribe a steroid taper for radiation and checkpoint inhibitor related pneumonitis?
I've seen a handful of fatal radiation pneumonitis associated with rapid steroid tapers by the non-treating physicians. How do you recommend prescribing a taper to prevent this?
Answer from: Radiation Oncologist at Academic Institution
I subscribe to the philosophy of "hitting hard, tapering slowly" for cases of pneumonitis, either radiation pneumonitis, or checkpoint inhibitor-related pneumonitis (some of those cases probably have mixed origin, with contributions from radiation and/or checkpoint inhibitors).
For severely symptom...
Comments
Radiation Oncologist at Yale School of Medicine Thank you so much. I was always taught to go slow ...
Medical Oncologist at Yuma Regional Medical Center Cancer Center As a rule of thumb, irAEs need a relatively long-t...
Radiation Oncologist at Yale School of Medicine Thanks for this. I think decreasing the dose to 20...
Approach to treatment-related pneumonitis, whether drug or radiation-induced, should always be governed by the severity of the presentation. In my opinion, any patient with severe symptoms, new oxygen requirements, or out-of-field findings on imaging should be managed in concert with a pulmonologist...
Thank you so much. I was always taught to go slow ...
As a rule of thumb, irAEs need a relatively long-t...
Thanks for this. I think decreasing the dose to 20...