High Frequency of Radiation Pneumonitis in Patients with Locally Advanced Non-small Cell Lung Cancer Treated with Concurrent Radiotherapy and Gemcitabine after Induction with Gemcitabine and Carboplatin

Arrieta, Óscar; Gallardo‐Rincón, Dolores; Villarreal‐Garza, Cynthia; Michel, Rosa M.; Astorga-Ramos, Alma Magdalena; Martínez-Barrera, Luis Manuel; Garza, Jaime de la

doi:10.1097/jto.0b013e3181a97e17

Cited by 60 publications

(53 citation statements)

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“…Compared with lung irradiation and gemcitabine administration alone, the combined effect of lung irradiation and gemcitabine in mice is synergistic, inducing a threefold increase in lung tissue TNF-a mRNA levels than would be expected from a single additive effect (Rübe et al 2004b). Concurrent radiotherapy with gemcitabine has been associated with excessive pulmonary toxicity (Arrieta et al 2009). Therefore, it is widely known that concurrent radiotherapy with gemcitabine should not be used apart from a clinical trial.…”

Section: Discussionmentioning

confidence: 99%

“…However, high rates of severe lung toxicity have been identified when combination chemotherapeutic regimens including gemcitabine were administered (Takeda et al 2009;Belknap et al 2006). Furthermore, gemcitabine and concurrent thoracic radiotherapy have been associated with a high incidence of severe pneumonitis (Arrieta et al 2009;Blackstock et al 2006). Thus, as per these reports, the incidence of ILD associated with gemcitabine treatment shows variation.…”

Section: Introductionmentioning

confidence: 99%

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Interstitial lung disease associated with gemcitabine treatment in patients with non-small-cell lung cancer and pancreatic cancer

Umemura

Yamane

Suwaki

et al. 2011

J Cancer Res Clin Oncol

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Interstitial lung disease associated with gemcitabine treatment in patients with non-small-cell lung cancer and pancreatic cancer

Umemura

Yamane

Suwaki

et al. 2011

J Cancer Res Clin Oncol

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“…Higher doses were tried, however quitted due to the increase in complication rate (36)(37)(38). Gemcitabine, a chemotherapeutic agent,highly increases RT toxicity (39,40). Moreover, the use of anthracyclines (like doxorubicin), methotrexate, and bleomycin during thoracic radiotherapy is contraindicated.…”

Section: Early (<90 Days) Late (>90 Days) Gradementioning

confidence: 99%

Pulmonary Toxicities and Treatment of Radiation Therapy

Argüder¹,

Yıldırım²,

Hasanoğlu³

2015

Eurasian J Pulmonol

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Radiotherapy (RT), used for the treatment of cancers, such as lung cancer, lymphoma, breast cancer, bone marrow transplantation, and esophageal cancer, causes the exposure of lungs to radiation. Since the lungs are very sensitive to ionizing radiation, radiation-induced lung diseases due to radiation therapy are usually common. In this article, lung diseases secondary to RT and the diagnosis and treatment of these diseases were evaluated in light of the literature.Keywords: Cancer, lung, radiotherapy, toxicity INTRODUCTIONThe exposure of normal tissues, besides cancerous tissues, to radiation from the first days of radiotherapy (RT) application has been an important limiting factor. Although the incidence of radiation-induced normal tissue injury has diminished with the development of radiation oncology technology in recent years, it still goes on. In this review, general information about RT is given, and RT-induced toxicity types that develop in the lungs and therapies are explained. GENERAL INFORMATIONRT is used for palliative, curative, adjuvant, and prophylactic purposes in cancer treatment. The aim during radiotherapy application is to reduce or remove tumor load while protecting normal tissue. The injury of normal tissue always poses the main obstacle to RT. In time, strategies, such as dose-volume modulation, image-guided RT applications, involved-field radiotherapy, and the use of lung disease-preventive agents, have been developed to overcome this problem Thoracic RT may be conducted in cases, such as lung cancer, bone marrow transplantation, and esophageal cancer. Lungs are among the most sensitive organs to ionizing radiation, and this sensitivity is one of the most important dose-limiting obstacles of thoracic RT. Temporary sequential inflammatory events are seen in the lung tissue as a response to radiation exposure. Here, individual differences, by affecting the outcome, bring about the occurrence of normal or pathological responses. Radiation-induced lung injury is a progressive process, including inflammation and repair. The development of injury may be prevented and the development of new strategies for treatment may be possible by understanding the underlying mechanisms of the basic molecular damage caused by radiotherapy (1, 2).Today, external RT (EBRT), brachytherapy, intraoperative RT (IORT), stereotactic RT (SRT), three-dimensional conformal RT (3D-CRT), intensity-modulated RT (IMRT), image-guided RT (IGRT), tomotherapy, cyberknife (robotic radiosurgery), boron neutron capture therapy, and hyperthermia are among RT applications. Location of the tumor, its histopathological feature, sensitivity to RT, the patient's undergoing surgical intervention, and his receiving chemotherapy are important for the preference of the appropriate technique (3). 150Radiation has an impact on the alveolocapillary unit of the lung according to the proliferation of cells. Endothelial, epithelial (particularly, type 2 pneumocytes producing surfactant), and reticuloendothelial system cells are more sensi...

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“…Gemcitabin wurde ebenfalls mit der Entwicklung einer medikamenteninduzierten Pneumonitis assoziiert [6,7,8]. Besonders in Verbindung mit einer simultanen thorakalen Strahlentherapie ist das Risiko für die Entwicklung einer Pneumonitis hoch.…”

Section: > Der Verlauf Einer Medikamenteninduzierten Pneumonitis Ist unclassified

“…Nach einer Induktionstherapie mit Carboplatin und Gemcitabin erhielten die Patienten eine simultane Radiochemotherapie unter Verwendung von Gemcitabin [8].…”

Section: Diagnose: Pemetrexed-induzierte Pneumonitisunclassified