Incidence of and risk factors for non-hematologic toxicity with combined radiotherapy and CDK4/6 inhibitors in metastatic breast cancer using dose-volume parameters analysis: a multicenter cohort study
Incidence of and risk factors for non-hematologic toxicity with combined radiotherapy and CDK4/6 inhibitors in metastatic breast cancer using dose-volume parameters analysis: a multicenter cohort study
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使用剂量-体积参数分析转移性乳腺癌联合放疗和 CDK4/6 抑制剂非血液毒性的发生率和危险因素：一项多中心队列研究
DOI：
10.1007/s12282-022-01422-5
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发表时间：
2022
期刊：
影响因子：
4
通讯作者：
Nakamura Naoki
中科院分区：
文献类型：
--
作者：
Kawamoto Terufumi;Shikama Naoto;Imano Nobuki;Kubota Hikaru;Kosugi Takashi;Sekii Shuhei;Harada Hideyuki;Yamada Kazunari;Naoi Yutaka;Miyazawa Kazunari;Hirano Yasuhiro;Wada Yuki;Tonari Ayako;Saito Tetsuo;Uchida Nobue;Araki Norio;Nakamura Naoki
背景缺乏关于联合放疗 (RT) 和细胞周期蛋白依赖性激酶 4 和 6 抑制剂 (CDK4/6i) 危险因素和毒性的数据。本研究旨在通过剂量-体积参数分析评估接受 RT 和 CDK4/6i 联合治疗的患者非血液学毒性的发生率和危险因素。方法我们对使用 CDK4/6i 14 天内接受 RT 的转移性乳腺癌患者进行了一项回顾性多中心队列研究。终点是非血液学毒性。比较中度以上毒性（≥2级）组和非中度毒性组的患者特征和RT治疗计划数据。结果本研究纳入60例患者。 palbociclib 和 abemaciclib 的 CDK4/6i 中位日剂量分别为 125 mg 和 200 mg。在同时接受 RT 和 CDK4/6i 的患者 (N=≥29) 中，CDK4/6i 的中位同时处方持续时间为 14 天。中位放疗剂量为 30 Gy，分 10 次。 2级和3级非血液学毒性发生率分别为30%和2%。同时使用和序贯使用 CDK4/6i 的毒性没有差异。与非中度肺炎组相比，中度肺炎组的肺 V20 当量剂量（每次分次 2 Gy）和计划目标体积更大。结论 RT 和 CDK4/6i 联合治疗时经常出现中度毒性。对于 RT 和 CDK4/6i 的组合，需要谨慎。特别是，对于联合 RT 和 CDK4/6i，减少对正常器官的剂量是必要的。
BackgroundThere is a lack of data on combined radiotherapy (RT) and cyclin-dependent kinase 4 and 6 inhibitor (CDK4/6i) risk factors and toxicity. This study aimed to assess the incidence of and risk factors for non-hematologic toxicities in patients treated with combined RT and CDK4/6i using dose-volume parameter analysis.MethodsWe conducted a retrospective multicenter cohort study of patients with metastatic breast cancer receiving RT within 14 days of CDK4/6i use. The endpoint was non-hematologic toxicities. Patient characteristics and RT treatment planning data were compared between the moderate or higher toxicities (≥ grade 2) group and the non-moderate toxicities group.ResultsSixty patients were included in the study. CDK4/6i was provided at a median daily dose of 125 mg and 200 mg for palbociclib and abemaciclib, respectively. In patients who received concurrent RT and CDK4/6i (N= 29), the median concurrent prescribed duration of CDK4/6i was 14 days. The median delivered RT dose was 30 Gy and 10 fractions. The rate of grade 2 and 3 non-hematologic toxicities was 30% and 2%, respectively. There was no difference in toxicity between concurrent and sequential use of CDK4/6i. The moderate pneumonitis group had a larger lung V20 equivalent dose of 2 Gy per fraction and planning target volume than the non-moderate pneumonitis group.ConclusionsModerate toxicities are frequent with combined RT and CDK4/6i. Caution is necessary concerning the combined RT and CDK4/6i. Particularly, reducing the dose to normal organs is necessary for combined RT and CDK4/6i.