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尼达尼布治疗症状性放射性肺炎。病例报告。

Nintedanib for the treatment of symptomatic radiation pneumonitis. A Case Report.

作者信息

Kuipers M E, Van Doorn-Wink K C J, Postmus P E

机构信息

Leiden University Medical Center (LUMC), Department of Pulmonology, C02-Q, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands.

Leiden University Medical Center (LUMC), Department of Radiotherapy, K01-P, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands.

出版信息

Heliyon. 2024 Jul 9;10(14):e34345. doi: 10.1016/j.heliyon.2024.e34345. eCollection 2024 Jul 30.

DOI:10.1016/j.heliyon.2024.e34345
PMID:39082015
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11284390/
Abstract

Radiation induced pneumonitis is a common side effect of thoracic radiotherapy. We report a case of a patient diagnosed with symptomatic radiation pneumonitis and a serious contra-indication for corticosteroids. For that reason, the patient was treated with nintedanib instead. After several weeks of treatment her symptoms and chest CT improved significantly. This case shows that nintedanib might be an effective treatment of radiation pneumonitis if corticosteroids are contra-indicated.

摘要

放射性肺炎是胸部放疗常见的副作用。我们报告一例被诊断为有症状放射性肺炎且有使用皮质类固醇严重禁忌证的患者。因此，该患者改用尼达尼布治疗。经过几周治疗，她的症状和胸部CT有显著改善。该病例表明，如果皮质类固醇有禁忌证，尼达尼布可能是治疗放射性肺炎的有效药物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3cd/11284390/f9e0912de6cf/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3cd/11284390/f9e0912de6cf/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3cd/11284390/f9e0912de6cf/gr1.jpg

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本文引用的文献

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Randomized Phase 2 Placebo-Controlled Trial of Nintedanib for the Treatment of Radiation Pneumonitis.尼达尼布治疗放射性肺炎的随机 2 期安慰剂对照试验。
Int J Radiat Oncol Biol Phys. 2023 Aug 1;116(5):1091-1099. doi: 10.1016/j.ijrobp.2023.02.030. Epub 2023 Mar 7.
2
Anti-VEGF Antibody Protects against Alveolar Exudate Leakage Caused by Vascular Hyperpermeability, Resulting in Mitigation of Pneumonitis Induced by Immunotherapy.抗血管内皮生长因子抗体可防止血管通透性增加引起的肺泡渗出液渗漏，从而减轻免疫治疗引起的肺炎。
Mol Cancer Ther. 2021 Dec;20(12):2519-2526. doi: 10.1158/1535-7163.MCT-21-0031. Epub 2021 Sep 22.
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Immunomodulation by radiotherapy in tumour control and normal tissue toxicity.
放射治疗在肿瘤控制和正常组织毒性中的免疫调节作用。
Nat Rev Immunol. 2022 Feb;22(2):124-138. doi: 10.1038/s41577-021-00568-1. Epub 2021 Jul 1.
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A Phase 2 Randomized, Double-Blind, Placebo-Controlled Study Evaluating Nintedanib Versus Placebo as Prophylaxis Against Radiation Pneumonitis in Patients With Unresectable NSCLC Undergoing Chemoradiation Therapy.一项2期随机、双盲、安慰剂对照研究，评估尼达尼布与安慰剂作为接受放化疗的不可切除非小细胞肺癌患者放射性肺炎预防药物的疗效。
J Thorac Oncol. 2021 Mar;16(3):e19-e20. doi: 10.1016/j.jtho.2020.11.019.
5
Bevacizumab for radiation necrosis following radiotherapy of brain metastatic disease: a systematic review & meta-analysis.贝伐单抗治疗脑转移瘤放疗后放射性坏死：系统评价与荟萃分析。
BMC Cancer. 2021 Feb 16;21(1):167. doi: 10.1186/s12885-021-07889-3.
6
Steroid-induced glaucoma: Epidemiology, pathophysiology, and clinical management.类固醇性青光眼：流行病学、病理生理学和临床管理。
Surv Ophthalmol. 2020 Jul-Aug;65(4):458-472. doi: 10.1016/j.survophthal.2020.01.002. Epub 2020 Feb 11.
7
Nintedanib in Progressive Fibrosing Interstitial Lung Diseases.尼达尼布治疗进行性纤维化间质性肺疾病。
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Oncoimmunology. 2015 Dec 29;5(5):e1123366. doi: 10.1080/2162402X.2015.1123366. eCollection 2016 May.