Drug-Related Pneumonitis During Mammalian Target of Rapamycin Inhibitor Therapy: Radiographic Pattern-Based Approach in Waldenstrom Macroglobulinemia as a Paradigm
Drug-Related Pneumonitis During Mammalian Target of Rapamycin Inhibitor Therapy: Radiographic Pattern-Based Approach in Waldenstrom Macroglobulinemia as a Paradigm
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DOI：
10.1634/theoncologist.2015-0033
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发表时间：
2015-09-01
期刊：
影响因子：
5.8
通讯作者：
Ramaiya, Nikhil H.
中科院分区：
文献类型：
--
作者：
Nishino, Mizuki;Boswell, Erica N.;Ramaiya, Nikhil H.
背景资料。本研究通过对华登斯特龙巨球蛋白血症患者在哺乳动物靶点雷帕霉素(MTOR)抑制剂治疗过程中，药物相关性肺炎的发生率进行检测，并对肺炎的影像特征和影像表现进行分析。共有40名患者(男性23名，女性17名；年龄43-84岁)在两次mTOR抑制剂依维莫司试验中接受治疗，进行了回顾性研究。根据三位放射科医生的共识，在治疗过程中对胸部CT扫描可疑药物相关性肺炎的异常进行审查，评估其范围、分布和特殊表现。根据美国胸科学会/欧洲呼吸学会对间质性肺炎的分类，对肺炎的放射学类型进行分类。有23名患者(58%)出现了与药物相关的肺炎。从开始治疗到肺炎发作的中位时间为5.7个月。23例患者下肺受累程度均高于其他部位(P<0.05)。
Background. This study determined the frequency of drug-related pneumonitis during mammalian target of rapamycin (mTOR) inhibitor therapy in Waldenstrom macroglobulinemia patients and investigated the imaging characteristics and radiographic patterns of pneumonitis.Materials and Methods. A total of 40 patients (23 men, 17 women; 43-84 years old) with Waldenstrom macroglobulinemia treated in 2 trials of the mTOR inhibitor everolimus were retrospectively studied. Chest computed tomography (CT) scans during therapy were reviewed for abnormalities suspicious for drug-related pneumonitis by the consensus of three radiologists, evaluating the extent, distributions, and specific findings. The radiographic patterns of pneumonitis were classified using the American Thoracic Society/European Respiratory Society classification of interstitial pneumonia.Results. Drug-related pneumonitis was noted in 23 patients (58%). The median time from the initiation of therapy to the onset of pneumonitis was 5.7 months. Lower lungs were involved in all 23 patients, with a higher extent than in the other zones (p