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细胞周期蛋白依赖性激酶抑制剂(CDKI)与放疗(RT)联合应用在转移性乳腺癌(MBC)治疗中的作用:临床实践中的优势与风险

Role of the Combination of Cyclin-Dependent Kinase Inhibitors (CDKI) and Radiotherapy (RT) in the Treatment of Metastatic Breast Cancer (MBC): Advantages and Risks in Clinical Practice.

作者信息

Gagliano Ambrogio, Prestifilippo Angela, Cantale Ornella, Ferini Gianluca, Fisichella Giacomo, Fontana Paolo, Sciacca Dorotea, Giuffrida Dario

机构信息

Department of Medical Oncology, The Mediterranean Institute of Oncology, Viagrande, Italy.

出版信息

Front Oncol. 2021 Jun 17;11:643155. doi: 10.3389/fonc.2021.643155. eCollection 2021.

Abstract

Targeting cell cycle has become the gold standard for metastatic breast cancer (MBC), being cyclin-dependent kinase inhibitors (CDKIs) cornerstones of its treatment, alongside radiotherapy (RT). To date, no definite evidence regarding safety and efficacy of the combination of CDKIs plus radiotherapy (RT) is currently available. Purpose of this review is to collect data in favor or against the feasibility of the association of CDKIs + RT, describing its potential adverse events. Our review shows how CDKI + RT allows an overall satisfying disease control, proving to be effective and causing a grade of toxicity mainly influenced by the site of irradiation, leaning to favourable outcomes for sites as liver, spine or brain and to poorer outcomes for thoracic lesions or sites close to viscera; controversial evidence is instead for bone treatment. Toxicity also varies from patient to patient. To sum up, our contribution enriches and enlightens a still indefinite field regarding the feasibility of CDKIs + RT, giving cues for innovative clinical management of hormone-responsive MBC.

摘要

针对细胞周期已成为转移性乳腺癌(MBC)的金标准,细胞周期蛋白依赖性激酶抑制剂(CDKIs)是其治疗的基石,与放射治疗(RT)一起。迄今为止,尚无关于CDKIs联合放射治疗(RT)安全性和有效性的确切证据。本综述的目的是收集支持或反对CDKIs + RT联合治疗可行性的数据,描述其潜在的不良事件。我们的综述表明,CDKI + RT可实现总体令人满意的疾病控制,证明是有效的,且毒性程度主要受照射部位影响,对于肝脏、脊柱或脑部等部位倾向于产生良好结果,而对于胸部病变或靠近内脏的部位则结果较差;相反,关于骨治疗的证据存在争议。毒性也因患者而异。总之,我们的贡献丰富并阐明了关于CDKIs + RT可行性的一个仍不明确的领域,为激素反应性MBC的创新临床管理提供了线索。

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