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英夫利昔单抗治疗宫颈癌放疗后严重不良反应 1 例报告

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

机构信息

Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sweden.

出版信息

J Int Med Res. 2023 Dec;51(12):3000605231208596. doi: 10.1177/03000605231208596.

Abstract

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.

摘要

盆腔放疗是治疗多种癌症的有效手段,包括妇科、前列腺、直肠和肛门癌。尽管离子束的传递得到了改善,但对非癌组织的损伤可能会导致潜在严重的长期影响,从而影响生活质量和日常功能。目前迫切需要新的策略来治疗和逆转盆腔放疗的副作用,同时又不影响抗肿瘤效果。一名患有严重放射性肠道副作用的女性接受肿瘤坏死因子-α抑制剂英夫利昔单抗治疗,剂量为 3mg/kg,每 4 至 6 周一次。用英夫利昔单抗治疗后,其肠道健康状况显著改善。患者的晚期肠道毒性从 2 级降至 0 级(RTOG/EORTC 晚期放射损伤量表)。尽管由于免疫抑制剂可能出现严重副作用的风险,需要谨慎行事,但我们的病例表明,英夫利昔单抗可用于治疗放疗后慢性肠道功能障碍的症状。

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Low-grade intestinal inflammation two decades after pelvic radiotherapy.盆腔放疗二十年后的低度肠道炎症。
EBioMedicine. 2023 Aug;94:104691. doi: 10.1016/j.ebiom.2023.104691. Epub 2023 Jul 20.
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Targeting cytokines in inflammatory bowel disease.针对炎症性肠病中的细胞因子
Sci Transl Med. 2022 Dec 14;14(675):eabq4473. doi: 10.1126/scitranslmed.abq4473.
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Gastrointestinal Toxicity of Pelvic Radiotherapy: Are We Letting Women Down?盆腔放射治疗的胃肠道毒性:我们是否让女性失望了?
Clin Oncol (R Coll Radiol). 2021 Sep;33(9):591-601. doi: 10.1016/j.clon.2021.04.009. Epub 2021 May 10.

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