Low-grade intestinal inflammation two decades after pelvic radiotherapy

Devarakonda, Sravani; Thorsell, Annika; Hedenström, Per; Rezapour, Azar; Heden, Lisen; Banerjee, Sanghita; Johansson, Malin E.V.; Birchenough, George; Toft Morén, Amelie; Gustavsson, Karin; Skokic, Viktor; Pettersson, Victor L.; Sjöberg, Fei; Kalm, Marie; Al Masri, Mohammad; Ekh, Michaela; Fagman, Henrik; Wolving, Mats; Perkins, Rosie; Morales, Rodrigo A.; Castillo, Francisca; Villablanca, Eduardo J.; Yrlid, Ulf; Bergmark, Karin; Steineck, Gunnar; Bull, Cecilia

doi:10.1016/j.ebiom.2023.104691

Cited by 3 publications

(1 citation statement)

References 44 publications

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“…We do not know if this is an exceptional case, as we have not identified earlier studies or case reports that attempted to treat radiationinduced bowel symptoms with infliximab. However, our own studies in a mouse model of pelvic radiotherapy [13][14][15] and biopsies from pelvic cancer survivors with chronic bowel dysfunction 16 suggest the presence of chronic low-grade inflammation in the radiation-exposed intestinal mucosa. Infliximab could improve low-grade inflammation, although we have no data supporting this hypothesis and it is unknown whether the inflammation was related to the patient's symptoms.…”

Section: Discussionmentioning

confidence: 86%

Remarkable effects of infliximab on severe radiation-induced side effects in a patient with uterine cervical cancer: a case report

Toft Morén,

Bull,

Bergmark

2023

J Int Med Res

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Pelvic radiotherapy is a powerful treatment for a broad range of cancers, including gynecological, prostate, rectal, and anal cancers. Despite improvements in the delivery of ionizing beams, damage to non-cancerous tissue can cause long-term effects that are potentially severe, affecting quality of life and daily function. There is an urgent need for new strategies to treat and reverse the side effects of pelvic radiotherapy without compromising the antitumor effect. A woman with severe radiation-induced intestinal side effects was treated with the tumor necrosis factor-alpha inhibitor infliximab with a dose of 3 mg/kg every 4 to 6 weeks. With infliximab treatment, a remarkable improvement in her bowel health was observed. The patient’s late bowel toxicity was reduced from Grade 2 to Grade 0 (RTOG/EORTC Late Radiation Morbidity Scale). Although it is necessary to proceed cautiously because of the risk of serious side effects from immunosuppressants, our case suggests that infliximab can be used to treat symptoms of chronic bowel dysfunction after radiotherapy.

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Section: Discussionmentioning

confidence: 86%

Remarkable effects of infliximab on severe radiation-induced side effects in a patient with uterine cervical cancer: a case report

Toft Morén,

Bull,

Bergmark

2023

J Int Med Res

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REGγ Mitigates Radiation-Induced Enteritis by Preserving Mucin Secretion and Sustaining Microbiome Homeostasis

Zhu,

Li,

Tian

et al. 2024

The American Journal of Pathology

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Association between prostate cancer and myocardial infarction management and post-infarction outcomes: A Norwegian registry study

Forster,

Kjellstadli,

Akerkar

et al. 2024

Preprint

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Background and aims: Prostate cancer (PCa) is the most frequently diagnosed cancer in men in Norway and as survival rates improve cardiovascular disease (CVD) has emerged as a primary cause of morbidity and mortality, including acute myocardial infarction (AMI). Cancer and CVD share some important risk factors and PCa treatment may increase the risk of CVD. The aim of this study was to compare rates of invasive management, in-hospital complications, major adverse cardiovascular events (MACE), re-infarction and death, as well as prescription of guideline recommended secondary pharmacological prevention after an AMI between PCa patients and the general male AMI population. Methods: Data included nation-wide registry data to identify all males 40-85 years in Norway who had their first AMI during 2013-2019. We compared outcomes after AMI between those diagnosed with localized PCa between 2004-2019 and the general AMI population using logistic and cause-specific Cox regression. Results: 34,362 AMI patients were included, of whom 1405 (4.1%) had PCa. No differences were observed in invasive management or secondary medical treatment post-AMI between PCa patients and non-cancer patients. While PCa patients had a lower risk of overall complications (OR 0.77; 0.64-0.92), they experienced an increased risk of serious bleeding (OR 1.66; 1.08-2.44) and no difference in MACE or re-infarction events. PCa patients had better 1-year survival (HR 0.82; 0.69-0.98). Conclusions: There was no evidence of reduced quality of AMI care for PCa patients in Norway. These findings support treatment of AMI as usual for localized PCa patients, but with attention to increased bleeding risk.

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Low-grade intestinal inflammation two decades after pelvic radiotherapy

Cited by 3 publications

References 44 publications

Remarkable effects of infliximab on severe radiation-induced side effects in a patient with uterine cervical cancer: a case report

Remarkable effects of infliximab on severe radiation-induced side effects in a patient with uterine cervical cancer: a case report

REGγ Mitigates Radiation-Induced Enteritis by Preserving Mucin Secretion and Sustaining Microbiome Homeostasis

Association between prostate cancer and myocardial infarction management and post-infarction outcomes: A Norwegian registry study

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