Effects of tamoxifen on pulmonary fibrosis after cobalt-60 radiotherapy in breast cancer patients

Koç, Mehmet; Polat, Pınar; Suma, Selamı

doi:10.1016/s0167-8140(02)00136-6

Cited by 81 publications

(49 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…64 In addition, tamoxifen seems to increase the risk of radiation-induced lung and skin fibrosis. [65][66][67] This paradoxical effect aggravating pulmonary fibrosis is likely dependent on the concurrent exposition to radiotherapy. Thus, it seems reasonable to assume that tamoxifen may not be appropriate for all fibrotic diseases.…”

Section: Discussionmentioning

confidence: 99%

Antifibrotic Effect of Tamoxifen in a Model of Progressive Renal Disease

Dellê

Rocha

Cavaglieri

et al. 2012

Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Tamoxifen, a selective estrogen receptor modulator, has antifibrotic properties; however, whether it can attenuate renal fibrosis is unknown. In this study, we tested the effects of tamoxifen in a model of hypertensive nephrosclerosis (chronic inhibition of nitric oxide synthesis with L-NAME). After 30 days, treated rats had significantly lower levels of albuminuria as well as lower histologic scores for glomerulosclerosis and interstitial fibrosis than untreated controls. Tamoxifen was renoprotective despite having no effect on the sustained, severe hypertension induced by L-NAME. Tamoxifen prevented the accumulation of extracellular matrix by decreasing the expression of collagen I, collagen III, and fibronectin mRNA and protein. These renoprotective effects associated with inhibition of TGF-b1 and plasminogen activator inhibitor-1, and with a significant reduction in a-smooth muscle actin-positive cells in the renal interstitium. Furthermore, tamoxifen abrogated IL-1b-and angiotensin-II-induced proliferation of fibroblasts from both kidney explants and from the NRK-49F cell line. Tamoxifen also inhibited the expression of extracellular matrix components and the production and release of TGF-b1 into the supernatant of these cells. In summary, tamoxifen exhibits antifibrotic effects in the L-NAME model of hypertensive nephrosclerosis, likely through the inhibition of TGF-b1, suggesting that it may have therapeutic use in CKD treatment.

show abstract

Section: Discussionmentioning

confidence: 99%

Antifibrotic Effect of Tamoxifen in a Model of Progressive Renal Disease

Dellê

Rocha

Cavaglieri

et al. 2012

Journal of the American Society of Nephrology

View full text Add to dashboard Cite

show abstract

“…In a recent prospective randomised study comparing breast pain after breast-conserving surgery and TAM with or without RT (Rayan et al, 2003), the incidence and severity of breast symptoms was similar at baseline in patients subsequently randomised to the RT and no-RT arms of the study. With lung fibrosis as an end point, contradictory reports have indicated that TAM could result in potentiation of postradiation normal tissue reactions Huang et al, 2000;Koc et al, 2002;Mahler, 2002;Christensen et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

Concomitant use of tamoxifen with radiotherapy enhances subcutaneous breast fibrosis in hypersensitive patients

et al. 2004

View full text Add to dashboard Cite

Concomitant use of adjuvant tamoxifen (TAM) and radiation therapy (RT) is not widely accepted. We aim to assess whether this treatment is associated with an increased risk of developing subcutaneous fibrosis after conservative or radical surgery in breast cancer patients. We analysed 147 women with breast cancer treated with adjuvant RT, and who were included in the KFS 00539-9-1997/SKL 00778-2-1999 prospective study aimed at evaluating the predictive value of CD4 and CD8 T-lymphocyte apoptosis for the development of radiation-induced late effects. TAM (20 mg day À1 ) with concomitant RT was prescribed in 90 hormone receptorpositive patients. There was a statistically significant difference in terms of complication-relapse-free survival (CRFS) rates at 3 years, 48% (95% CI 37.2 -57.6%) vs 66% (95% CI 49.9 -78.6%) and complication-free survival (CFS) rates at 2 years, 51% (95% CI 40 -61%) vs 80% (95% CI 67 -89%) in the TAM and no-TAM groups, respectively. In each of these groups, the CRFS rates were significantly lower for patients with low levels of CD8 radiation-induced apoptosis, 20% (95% CI 10 -31.9%), 66% (95% CI 51.1 -77.6%), and 79% (95% CI 55 -90.9%) for CD8 p16, 16 -24, and 424%, respectively. Similar results were observed for the CFS rates. The concomitant use of TAM with RT is significantly associated with an increased incidence of grade 2 or greater subcutaneous fibrosis; therefore, caution is needed for radiosensitive patients.

show abstract

“…91,92 Tamoxifen and various chemotherapy agents have been associated with increased pulmonary side effects with PMRT. [93][94][95][96] Among 1624 women treated with radiotherapy to the breast or chest wall alone or locoregional radiotherapy to the breast or chest wall plus lymph nodes, pneumonitis developed in 3% of patients treated with locoregional radiotherapy and chemotherapy compared with 0.5% in all other patients (p = 0.0001) (level V evidence). 91 Radiation pneumonitis occurred in 8.8% of patients receiving concurrent locoregional radiotherapy and chemotherapy, as compared with 1.3% of patients receiving sequential treatment (p = 0.002).…”

Section: Pulmonary Toxicitiesmentioning

confidence: 99%

“…95 Another study reported pulmonary fibrosis in 26 of 74 patients treated with concurrent tamoxifen and PMRT, as compared with 5 of 37 patients treated with PMRT alone (p = 0.01) (level V evidence). 96 The authors hypothesized that tamoxifen may enhance radiation fibrosis by inducing transforming growth factor-beta secretion. 95,96 In summary, the optimal sequencing of PMRT with systemic therapy remains to be defined.…”

Section: Sequencing Of Radiotherapy and Systemic Therapymentioning

confidence: 99%

“…96 The authors hypothesized that tamoxifen may enhance radiation fibrosis by inducing transforming growth factor-beta secretion. 95,96 In summary, the optimal sequencing of PMRT with systemic therapy remains to be defined. Many centres favour the administration of systemic chemotherapy before locoregional radiotherapy.…”

Section: Sequencing Of Radiotherapy and Systemic Therapymentioning

confidence: 99%

See 1 more Smart Citation