Patients with interstitial lung disease (ILD), especially those with pulmonary fibrosis, are at increased risk of developing lung cancer. Management of lung cancer in patients with ILD is particularly challenging. Diagnosis can be complicated by difficulty differentiating lung nodules from areas of focal fibrosis, and percutaneous biopsy approaches confer an increased risk of complications in those with pulmonary fibrosis. Lung cancer treatment in these patients pose several specific considerations. The degree of lung function impairment may preclude surgical resection of any type. Surgical resection can trigger an acute exacerbation of the underlying ILD. The presence of ILD confers an increased risk of pneumonitis with radiotherapy, as well as systemic therapies. This activity educates practicing radiation oncologists on how to recognize and categorize ILD, seek multi-disciplinary input into evaluation and management of patients with ILD, include routine use of ILD-GAP score into clinical practice in order to balance the risk of lung cancer progression vs. death from ILD, and manage pneumonitis and acute exacerbations of the underlying ILD after radiation therapy. 

Topics:

1. Breathing New Life into Interstitial Lung Disease for Practicing Radiation Oncologists
   Timur Mitin, MD, PhD
2. Interstitial Lung Disease: Diagnosis, Assessment and Management
   Cheilonda Johnson, MD, MHS
3. Radiological Evaluation of Interstitial Lung Disease (ILD)
   Mizuki Nishino, MD, MPH
4. Radiation Therapy for Lung Cancer Patients with ILD
   Christopher D. Goodman, MD, FRCPC
5. Q and A
   Timur Mitin, MD, PhD - Moderator
   Full Panel

This activity is available from July 28, 2025, through 11:59 p.m. Eastern time on July 27, 2027. 

The content was originally presented and recorded at the 2024 ASTRO Annual Meeting.