Expert consensus on cancer treatment-related lung injury

Lin, X.; Guo, H.; Zhao, W.; Li, M.; Lin, G.; Chu, Q.; Chen, E.; Chen, L.; Chen, R.; Chu, T.; Deng, H.; Deng, Y.; Dong, H.; Dong, W.; Dong, Y.; Fang, W.; Gan, X.; Gong, L.; Gu, Y.; Han, Q.; Hao, Y.; He, Y.; Hu, C.; Hu, J.; Hu, Y.; Jiang, Y.; Jin, Y.; Lan, F.; Li, W.; Li, W.; Liang, W.; Liu, A.; Liu, D.; Liu, M.; Liu, M.; Liu, Z.; Liu, Z.; Luo, Q.; Miao, L.; Mu, C.; Pan, P.; Peng, P.; Qin, J.; Qin, Y.; Shen, P.; Shi, M.; Song, Y.; Su, C.; Su, J.; Su, X.; Tan, X.; Tang, K.; Tang, X.; Tian, P.; Wang, B.; Wang, H.; Wang, K.; Wang, M.; Wang, Q.; Wang, W.; Wang, Z.; Wu, D.; Xu, F.; Xu, Y.; Xu, C.; Xie, Z.; Xie, X.; Yang, B.; Yang, M.; Ye, F.; Ye, X.; Yu, Z.; Zhang, J.; Zhang, J.; Zhang, X.; Zhao, F.; Zheng, X.; Zhu, B.; Zhu, Z.; Zhou, J.; Zhou, J.; Zhou, M.; Zhou, Q.; Zou, Z.; Kidane, B.; Bignami, E.; Sakamaki, F.; Roviello, G.; Taniguchi, H.; Jeon, K.; Saric, L.; Ariza-Prota, M.; La-Beck, N. M.; Kanaji, N.; Watanabe, S.; Shukuya, T.; Akaba, T.; Leong, T. L.; Gesierich, W.; Koga, Y.; Tanino, Y.; Uehara, Y.; Li, S.; Chen, R.; Zhou, C.

doi:10.21037/jtd-2025-292

Background: Although advancements in cancer therapies have substantially improved the survival of cancer patients, these treatments may also result in acute or chronic lung injury. Cancer treatment-related lung injury (CTLI) presents with a diverse array of clinical manifestations and can involve multiple sites. Due to the lack of specific diagnostic protocols, CTLI can deteriorate rapidly and may be life-threatening if not promptly addressed. Unfortunately, there is no universally accepted consensus document on the diagnosis and management of CTLI. Methods: A multidisciplinary panel comprising experts from respiratory and critical care medicine, oncology, radiation oncology, thoracic surgery, radiology, pathology, infectious diseases, pharmacy, and rehabilitation medicine participated in this consensus development. Through a systematic literature review and detailed panel discussions, the team formulated nine key recommendations. Results: This consensus document addresses the concept, epidemiology, pathogenesis, risk factors, diagnostic approach, evaluation workflow, management strategies, differential diagnosis, type-specific management and clinical staging of CTLI. Emphasis is placed on raising awareness among clinicians and therapeutic practices through comprehensive guidelines. Conclusions: The consensus provides a detailed diagnostic protocol for CTLI and introduces a structured management framework based on grading, typing, and staging. It highlights the critical role of multidisciplinary team (MDT) collaboration and emphasizes the need for individualized, whole-process patient care strategies to optimize clinical outcomes.

Expert consensus on cancer treatment-related lung injury / Lin, X.; Guo, H.; Zhao, W.; Li, M.; Lin, G.; Chu, Q.; Chen, E.; Chen, L.; Chen, R.; Chu, T.; Deng, H.; Deng, Y.; Dong, H.; Dong, W.; Dong, Y.; Fang, W.; Gan, X.; Gong, L.; Gu, Y.; Han, Q.; Hao, Y.; He, Y.; Hu, C.; Hu, J.; Hu, Y.; Jiang, Y.; Jin, Y.; Lan, F.; Li, W.; Li, W.; Liang, W.; Liu, A.; Liu, D.; Liu, M.; Liu, M.; Liu, Z.; Liu, Z.; Luo, Q.; Miao, L.; Mu, C.; Pan, P.; Peng, P.; Qin, J.; Qin, Y.; Shen, P.; Shi, M.; Song, Y.; Su, C.; Su, J.; Su, X.; Tan, X.; Tang, K.; Tang, X.; Tian, P.; Wang, B.; Wang, H.; Wang, K.; Wang, M.; Wang, Q.; Wang, W.; Wang, Z.; Wu, D.; Xu, F.; Xu, Y.; Xu, C.; Xie, Z.; Xie, X.; Yang, B.; Yang, M.; Ye, F.; Ye, X.; Yu, Z.; Zhang, J.; Zhang, J.; Zhang, X.; Zhao, F.; Zheng, X.; Zhu, B.; Zhu, Z.; Zhou, J.; Zhou, J.; Zhou, M.; Zhou, Q.; Zou, Z.; Kidane, B.; Bignami, E.; Sakamaki, F.; Roviello, G.; Taniguchi, H.; Jeon, K.; Saric, L.; Ariza-Prota, M.; La-Beck, N. M.; Kanaji, N.; Watanabe, S.; Shukuya, T.; Akaba, T.; Leong, T. L.; Gesierich, W.; Koga, Y.; Tanino, Y.; Uehara, Y.; Li, S.; Chen, R.; Zhou, C.. - In: JOURNAL OF THORACIC DISEASE. - ISSN 2072-1439. - 17:4(2025), pp. 1844-1875. [10.21037/jtd-2025-292]