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没食子儿茶素没食子酸酯治疗接受放疗的癌症患者急性重症皮炎的疗效和安全性:一项 I 期临床试验。

Efficacy and safety of epigallocatechin-3-gallate in treatment acute severe dermatitis in patients with cancer receiving radiotherapy: a phase I clinical trial.

机构信息

Department of Radiation Oncology, Shandong First Medical University Affiliated Cancer Hospital (Shandong Academy of Medical Sciences), Jinan, 250117, Shandong, China.

Department of Radiation Oncology, The Fourth People's Hospital of Jinan, Jinan, 250031, Shandong, China.

出版信息

Sci Rep. 2023 Aug 24;13(1):13865. doi: 10.1038/s41598-023-40881-4.

Abstract

To evaluate the safety and effectiveness of epigallocatechin-3-gallate (EGCG) solution treating the acute severe dermatitis in patients receiving radiotherapy. This phase I research enrolled patients with thoracic cancer receiving radiotherapy at Shandong Cancer Hospital and Institute in Shandong, China. EGCG solution was sprayed to the radiation field when grade III radiation-induced dermatitis (RID) first appearance. EGCG concentration escalated from 660 to 2574 μmol/L using modified-Fibonacci dose-escalation. RID and related symptoms were followed up every day. Between March 2021 and November 2021, 19 patients were enrolled in this phase I research. The median dose of grade III RID first observation was 44 Gy (30.6-52 Gy). As the EGCG treatment was performed continuously, all these grade III RID reactions were significantly decreased to grade I or grade II RID at three days after use of EGCG (p < 0.001). Significant relief can be observed in burning sensation (p < 0.001), tractive sensation (p < 0.001), tenderness (p < 0.001), erythema (p < 0.001), itching (p < 0.001) and pain (p < 0.001) after 15 days of EGCG treatment. No radiation therapy delay or interruption for all 19 patients. No adverse events were observed and reported associated with EGCG. The highest dose of this Phase I trial (2574 μmol/L) was recommended for continuous Phase II trial for further evaluation. In this phase I clinical research, use of EGCG solution is safe and can significantly relief grade III RID in patients receiving radiotherapy. Thus, EGCG might be a new choice for acute sever RID.Trial Registration: ClinicalTrials.gov Identifier: NCT02580279 (Full date of first registration: 12/2014).

摘要

评估表没食子儿茶素没食子酸酯(EGCG)溶液治疗接受放射治疗的患者急性重度放射性皮炎的安全性和有效性。这项 I 期研究招募了在中国山东癌症医院和研究所接受放射治疗的胸部癌症患者。当出现 3 级放射性诱导皮炎(RID)时,将 EGCG 溶液喷洒到放射野。EGCG 浓度使用改良的 Fibonacci 剂量递增法从 660 增加到 2574μmol/L。每天监测 RID 及相关症状。2021 年 3 月至 2021 年 11 月,19 名患者入组该 I 期研究。首次观察到 3 级 RID 的中位剂量为 44Gy(30.6-52Gy)。由于 EGCG 治疗持续进行,所有这些 3 级 RID 反应在使用 EGCG 后 3 天均明显降至 1 级或 2 级 RID(p<0.001)。使用 EGCG 治疗 15 天后,烧灼感(p<0.001)、牵拉感(p<0.001)、压痛(p<0.001)、红斑(p<0.001)、瘙痒(p<0.001)和疼痛(p<0.001)均有明显缓解。所有 19 名患者均未因放射治疗延迟或中断。未观察到与 EGCG 相关的不良反应事件。推荐最高剂量(2574μmol/L)进行连续的 II 期试验,以进一步评估。在这项 I 期临床研究中,EGCG 溶液的使用是安全的,可以显著缓解接受放射治疗的患者的 3 级 RID。因此,EGCG 可能是急性严重 RID 的新选择。试验注册:ClinicalTrials.gov 标识符:NCT02580279(首次注册的完整日期:2014 年 12 月)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f92/10449912/9b9f78e397cc/41598_2023_40881_Fig1_HTML.jpg

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