Concurrent use of aromatase inhibitors and hypofractionated radiation therapy

Chargari, Cyrus; Castro-Pena, P.; Toledano, I.; Ma, Bollet; Savignoni, Alexia; Cottu, Paul‐Henri; Laki, Fatima; Campana, F.; P, de Cremoux; Ym, Kirova

doi:10.4329/wjr.v4.i7.318

Cited by 6 publications

(3 citation statements)

References 20 publications

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“…Concurrent AI did not decrease the efficacy of irradiation at a median follow-up of 26 months. Moreover, Chargari et al [ 15 ] (2012) evaluated the toxicity of concurrent use of AI and hypofractionated RT in 19 patients. At the end of the RT course, acute toxicity was low in most patients, with only 1 grade 3 cutaneous toxicity.…”

Section: Resultsmentioning

confidence: 99%

Combination of Modern Radiotherapy and New Targeted Treatments for Breast Cancer Management

Beddok

Cottu

Kirova

2021

Cancers

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Background: The objective of the present study was to review the essential knowledge about the combinations of the most commonly used or under development targeted treatments and radiation therapy (RT). Methods: Preclinical and clinical studies investigating this combination were extensively reviewed. Results: Several studies showed that the combination of RT and tamoxifen increased the risk of radiation-induced pulmonary toxicity; therefore, both modalities should not be given concomitantly. The combination of HER2 inhibitors (trastuzumab, pertuzumab) and RT seems to be safe. However, trastuzumab emtansine (T-DM1) should not be administered concurrently with brain RT since this combination could increase the risk of brain radionecrosis. The combination of RT and other new target treatments such as selective estrogen receptor degradants, lapatinib, cell cycle inhibitors, immune checkpoint inhibitors, or molecules acting on DNA damage repair seems feasible but was essentially evaluated on retrospective or prospective studies with a small number of patients. Furthermore, there is considerable heterogeneity among these studies regarding the dose and fractionation of radiation, the dosage of drugs, and the sequence of treatments used. Conclusions: The combination of RT with most targeted therapies for BC appears to be well-tolerated, but these results need to be confirmed in prospective randomized studies.

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Section: Resultsmentioning

confidence: 99%

Combination of Modern Radiotherapy and New Targeted Treatments for Breast Cancer Management

Beddok

Cottu

Kirova

2021

Cancers

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“…Several cases of pneumopathy with anti-aromatase have been reported [35,38,39] and the time to start adjuvant hormonotherapy in patients who will receive postoperative radiotherapy remain controversial moreover with hypofractionnated scheme in which dose per fraction can rise 2.67 to 6 Gy [40,41]. A study shown mild to moderate toxicity but not designed for assessment of lung toxicity [42]. Treatment should depend on the severity of clinical conditions, and considering the adverse effects of prolonged corticosteroids and risk of relapse [43].…”

Section: Discussionmentioning

confidence: 99%

Bronchiolitis Obliterans Organizing Pneumonia after Breast Cancer Radiotherapy and letrozole: A Case Report and Literature Review

Aurélia¹,

Clavère²,

Léobon³

2021

AMCRCS

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Objectives: Bronchiolitis obliterans organizing pneumonia occurs with prevalence rate 1–3% after breast conservative treatment in series. In response to radiation of a lung or surrounding tissues, an inflammatory reaction can affect both lungs and is located within the radiation field. Characteristic imaging features include multiple alveolar opacities and diffuse ground-glass shadows. Letrozole may induce iatrogenic organizing pneumonia. Materials and methods: we report the case of a 76-year-old female who underwent conservative treatment for an invasive ductal carcinoma of the left breast. Hypofractionated radiotherapy was delivered with a total dose of 42.5 Gy in 16 sessions of 2.65 Gy using a three-dimensional technique. After the radiotherapy ended letrozole was indicated. Results: Several weeks after the radiotherapy ended and letrozole was introduced, she described a flu-like syndrome. Samples were negative, and there was no improvement after four courses of antibiotics. Imaging suggested bronchiolitis obliterans organizing pneumonia. Her symptomatology lessened after the letrozole was discontinued, and 11 months after radiotherapy finished, her imaging results were clear. Conclusion: Physicians must consider bronchiolitis obliterans organizing pneumonia. Cases may increase with hypofractionated radiation treatment and new drugs. Letrozole may potentiate the risk. Dosimetry may be adapted to the lung and subpleural areas for patients with risk factors and taking adjuvant or concurrent drugs with potential pneumotoxicity.

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“…We would like also to mark in the conclusion that clinical tests have been successfully conducted lately with application of hyperfractionation in those cases when usually traditional prolonged courses of tumor irradiation had been used [12,13], including the cases when the tumor irradiation scheme was applied-once a week [14,15], and in palliative ray therapy [16,17].…”

Section: Discussionmentioning

confidence: 99%

Effects of Hypofractionated and Standard Fractionated Irradiation of Mice Heads with Gamma-Rays and Protons on Their Pheripheral Blood Parameters and Behavior

Voskanyan¹,

Rzyanina²,

Borowicz³

et al. 2016

JPSA

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Experiments were performed to study the action of fractionated irradiation of mice heads with -rays and protons on their peripheral blood parameters and behavior by the "Open Field" test. Mice were irradiated in two variants of fractionated irradiation: (1) traditional fractionation (in radiation therapy): 2 Gy once a day, 5 times a week, the total radiation dose 20 Gy; (2) extreme hypofractionation: 10 Gy once a week, on Mondays, the total radiation dose 20 Gy. The results of the study showed that irradiation of mice heads has no effect on their peripheral blood parameters in both variants of the applied fractionated irradiation and the behavior of mice does not depend on the type of ionizing radiation and the variant of fractionated exposure that we used. On the basis of these results it can be concluded that the option of extreme hypofractionation we have chosen can successfully replace traditional fractionation, which in some cases is applied when carrying out radiotherapy for treating brain tumors. The application of this type of fractionation can lead to shorter terms of radiotherapy and bigger patient capacity of medical centers that conduct radiotherapy.

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Concurrent use of aromatase inhibitors and hypofractionated radiation therapy

Abstract: AIM:To retrospectively assess the acute and long-term toxicity using aromatase inhibitors (AI) therapy concurrently with hypofractionated radiotherapy (HFRT) in breast cancer patients.

Cited by 6 publications

References 20 publications

Combination of Modern Radiotherapy and New Targeted Treatments for Breast Cancer Management

Combination of Modern Radiotherapy and New Targeted Treatments for Breast Cancer Management

Bronchiolitis Obliterans Organizing Pneumonia after Breast Cancer Radiotherapy and letrozole: A Case Report and Literature Review

Effects of Hypofractionated and Standard Fractionated Irradiation of Mice Heads with Gamma-Rays and Protons on Their Pheripheral Blood Parameters and Behavior

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