Kataoka M, Kawamura M, Nishiyama Y, Higashino H, Fujii T, Mogami H, Itoh H, Iio A, Hamamoto K
Department of Radiology, Ehime University School of Medicine.
Nihon Igaku Hoshasen Gakkai Zasshi. 1992 May 25;52(5):641-5.
Radiation pneumonitis usually occurs within 1-3 months after the completion of radiation therapy. A 63-year-old male with primary lung cancer treated by radiation therapy developed radiation pneumonitis 5 months after the completion of radiation therapy. He received 60 Gy to the lung tumor in a conventional fractionation schedule, and then two courses of intravenous chemotherapy using cis-diamine-dichloroplatinum (II) (110-140 mg) and etoposide (140-175 mg). Oral etoposide was initiated for bone metastases on the 104th day after the completion of radiation therapy at a daily dose of 20 mg, to a total dose of 1075 mg. He complained of fever and exertional dyspnea 5 months after the completion of radiation therapy. Chest radiography showed homogeneous infiltrates in the irradiated lung. These clinical signs and symptoms were refractory to antibiotic therapy, but steroid therapy resulted in marked improvement. The development of radiation pneumonitis was suspected to be induced by oral etoposide, which was given before the onset of radiation pneumonitis. These data suggest that etoposide induces a recall phenomenon, as has been demonstrated with such drugs as adriamycin and actinomycin-D.
放射性肺炎通常发生在放射治疗结束后的1 - 3个月内。一名63岁接受放射治疗的原发性肺癌男性患者，在放射治疗结束5个月后发生了放射性肺炎。他按照常规分割方案接受了60 Gy的肺部肿瘤照射，然后进行了两个疗程的静脉化疗，使用顺二氯二氨铂（II）（110 - 140 mg）和依托泊苷（140 - 175 mg）。在放射治疗结束后的第104天开始口服依托泊苷治疗骨转移，每日剂量20 mg，总剂量1075 mg。他在放射治疗结束5个月后出现发热和劳力性呼吸困难。胸部X线检查显示照射肺部有均匀的浸润影。这些临床症状对抗生素治疗无效，但类固醇治疗后有明显改善。放射性肺炎的发生被怀疑是由在放射性肺炎发病前给予的口服依托泊苷诱导的。这些数据表明依托泊苷会诱发回忆现象，正如阿霉素和放线菌素-D等药物所证实的那样。
