부산대학교 도서관

Background. Radiation recall pneumonitis (RRP) has been reported to occur after prior irradiation by various drugs. Case. The patient was a 49-year-old male who underwent concurrent chemoradiotherapy for stage IIIA squamous cell lung cancer since November 2017. The patient developed grade 2 radiation pneumonitis in March 2018, and the pneumonitis improved with prednisolone (PSL) medication. He remained under observation subsequently. In July 2021, computed tomography (CT) showed enlarged mediastinal lymph nodes in the radiation field, and the patient was diagnosed with recurrence and started on nivolumab+ipilimumab. On day 22 of cycle 1, dry cough appeared, and CT showed a ground-glass opacity and consolidation around the radiation pneumonitis scar within the previous irradiation area, which led to the diagnosis of RRP. PSL (0.5 mg/kg) was started, and nivolumab+ipilimumab was resumed when the PSL dose was tapered to 5 mg/body after improvement of RRP. However, on day 21 after resumption of nivolumab+ipilimumab, RRP relapsed at grade 3, and PSL (1.0 mg/kg) was started. Conclusion. Immune checkpoint inhibitors are causative agents of RRP and should be treated with caution.