Early onset recall pneumonitis during targeted therapy with sunitinib.
Early onset recall pneumonitis during targeted therapy with sunitinib.
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DOI：
10.1186/1471-2407-13-3
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发表时间：
2013-01-02
期刊：
影响因子：
3.8
通讯作者：
Yonese J
中科院分区：
文献类型：
--
作者：
Yuasa T;Kitsukawa S;Sukegawa G;Yamamoto S;Kudo K;Miyazawa K;Kozuka T;Harada S;Yonese J
舒尼替尼与放射治疗相互作用，导致这些治疗的毒性产生协同作用。放射记忆性肺炎是酪氨酸激酶抑制剂靶向治疗的一种罕见但严重的并发症。本文报道了一名转移性肾细胞癌 (RCC) 患者在舒尼替尼系统治疗的第一个周期中出现回忆性肺炎的病例。一名患有肾细胞癌和骨转移的 65 岁男性接受了胸椎（Th5-8）放射治疗，总剂量为 24 Gy。完成放射治疗 14 天后开始舒尼替尼 (37.5 mg)。舒尼替尼治疗第14天，患者出现进行性发热，呼吸困难和全身无力加重。开始用泼尼松龙 1,000 mg 脉冲给药 3 天进行治疗。此后，症状和间质滤过的放射学检查结果在 7 天内逐渐改善。据我们所知，这是舒尼替尼治疗期间首次出现早发性回忆性肺炎的报告。目前，舒尼替尼如何与放射治疗相互作用仍不清楚。应牢记放疗后酪氨酸激酶抑制剂治疗（包括舒尼替尼）可能导致不良反应的可能性。
Sunitinib interacts with radiation therapy, leading to synergism of the toxicities of these treatments. Radiation recall pneumonitis is a rare but serious complication of targeted therapy with tyrosine kinase inhibitors. The case of a patient with metastatic renal cell cancer (RCC) who developed recall pneumonitis on the first cycle of systemic sunitinib treatment is reported here. A 65-year-old man with RCC and bone metastasis underwent radiation therapy on his thoracic vertebrae (Th5-8) with a total dose of 24 Gy. Sunitinib (37.5 mg) was started 14 days after completing the radiation therapy. On the 14th day of sunitinib treatment, the patient developed progressive fever with worsening of dyspnea and general weakness. Treatment with pulse administration of prednisolone 1,000 mg for 3 days was initiated. Thereafter, the symptoms and the radiological findings regarding the interstitial filtration gradually improved over 7 days. To our knowledge, this is the first report of early onset recall pneumonitis during sunitinib therapy. At present, how sunitinib interacts with radiation therapy remains unclear. The possibility that tyrosine kinase inhibitor therapy, including with sunitinib, after radiation therapy may lead to adverse effects should be kept in mind.