The Impact of Everolimus and Radiation Therapy on Pulmonary Fibrosis
<i>Background and objectives:</i> Everolimus (EVE) is a mammalian target of the rapamycin (mTOR) inhibitor that is widely used in cancer patients. Pulmonary toxicity, usually manifesting as interstitial pneumonitis, is a serious adverse effect of this drug. Radiation therapy, which is of...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-07-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1010-660X/56/7/348 |
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| author | Mehmet Fuat Eren Ayfer Ay Eren Mutlay Sayan Birsen Yücel Şahende Elagöz Yıldıray Özgüven Irina Vergalasova Ahmet Altun Saadettin Kılıçkap Vasudev Daliparty Nuran Beşe |
| author_facet | Mehmet Fuat Eren Ayfer Ay Eren Mutlay Sayan Birsen Yücel Şahende Elagöz Yıldıray Özgüven Irina Vergalasova Ahmet Altun Saadettin Kılıçkap Vasudev Daliparty Nuran Beşe |
| author_sort | Mehmet Fuat Eren |
| collection | DOAJ |
| description | <i>Background and objectives:</i> Everolimus (EVE) is a mammalian target of the rapamycin (mTOR) inhibitor that is widely used in cancer patients. Pulmonary toxicity, usually manifesting as interstitial pneumonitis, is a serious adverse effect of this drug. Radiation therapy, which is often administered in conjunction with chemotherapy for synergistic effects, also causes pulmonary fibrosis. In view of pulmonary damage development in these two forms of cancer treatment, we have examined the effect of EVE administration individually, in combination with radiation given in varying sequences, and its relation to the extent of pulmonary damage. <i>Materials and Methods:</i> We performed an experimental study in albino rats, which were randomized into five groups: (1) control group, (2) EVE alone, (3) EVE 22 h after radiation, (4) EVE 2 h after irradiation, and (5) only radiation. Sixteen weeks after thoracic irradiation, rat lung tissue samples were examined under light microscopy, and the extent of pulmonary damage was estimated. After this, we calculated median fibrosis scores in each group. <i>Results:</i> The highest fibrosis score was noted in Group 4. Among the five groups, the control group had a significantly lower median fibrosis score compared to the others. When the median fibrosis score of the group that received concurrent EVE with radiation therapy (RT) (Group 4) was compared with that of the control group, the difference was statistically significant (<i>p</i> = 0.0022). However, no significant differences were achieved among the study groups that received EVE only or RT only, whether concurrently or sequentially (<i>p</i> > 0.05). <i>Conclusion:</i> EVE is an effective treatment option for the management of several malignancies and is often combined with other therapies, such as radiation, for a more efficient response. However, an increased risk of pulmonary fibrosis should also be anticipated when these two modalities are combined, as they both can cause pulmonary damage, especially when administered concurrently. |
| first_indexed | 2024-03-12T06:46:30Z |
| format | Article |
| id | doaj.art-c14c56b70d294f88b182fb20658a4121 |
| institution | Directory Open Access Journal |
| issn | 1010-660X |
| language | English |
| last_indexed | 2024-03-12T06:46:30Z |
| publishDate | 2020-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-c14c56b70d294f88b182fb20658a41212023-09-03T00:34:32ZengMDPI AGMedicina1010-660X2020-07-015634834810.3390/medicina56070348The Impact of Everolimus and Radiation Therapy on Pulmonary FibrosisMehmet Fuat Eren0Ayfer Ay Eren1Mutlay Sayan2Birsen Yücel3Şahende Elagöz4Yıldıray Özgüven5Irina Vergalasova6Ahmet Altun7Saadettin Kılıçkap8Vasudev Daliparty9Nuran Beşe10Radiation Oncology Clinic, M.H. Marmara University Pendik Education and Research Hospital, 34899 İstanbul, TurkeyRadiation Oncology Clinic, Kartal Dr. Lütfi Kırdar Education and Research Hospital, 34890 İstanbul, TurkeyDepartment of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USADepartment of Radiation Oncology, Cumhuriyet University School of Medicine, 58140 Sivas, TurkeyDepartment of Pathology, Cumhuriyet University School of Medicine, 58140 Sivas, TurkeyDepartment of Medical Physics, Trakya University School of Medicine, 22030 Edirne, TurkeyDepartment of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USADepartment of Pharmacology, Cumhuriyet University School of Medicine, 58140 Sivas, TurkeyDepartment of Preventive Oncology, Hacettepe University School of Medicine, 06230 Ankara, TurkeyDepartment of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USADepartment of Radiation Oncology, Medicine Faculty, Acibadem University, 34457 Istanbul, Turkey<i>Background and objectives:</i> Everolimus (EVE) is a mammalian target of the rapamycin (mTOR) inhibitor that is widely used in cancer patients. Pulmonary toxicity, usually manifesting as interstitial pneumonitis, is a serious adverse effect of this drug. Radiation therapy, which is often administered in conjunction with chemotherapy for synergistic effects, also causes pulmonary fibrosis. In view of pulmonary damage development in these two forms of cancer treatment, we have examined the effect of EVE administration individually, in combination with radiation given in varying sequences, and its relation to the extent of pulmonary damage. <i>Materials and Methods:</i> We performed an experimental study in albino rats, which were randomized into five groups: (1) control group, (2) EVE alone, (3) EVE 22 h after radiation, (4) EVE 2 h after irradiation, and (5) only radiation. Sixteen weeks after thoracic irradiation, rat lung tissue samples were examined under light microscopy, and the extent of pulmonary damage was estimated. After this, we calculated median fibrosis scores in each group. <i>Results:</i> The highest fibrosis score was noted in Group 4. Among the five groups, the control group had a significantly lower median fibrosis score compared to the others. When the median fibrosis score of the group that received concurrent EVE with radiation therapy (RT) (Group 4) was compared with that of the control group, the difference was statistically significant (<i>p</i> = 0.0022). However, no significant differences were achieved among the study groups that received EVE only or RT only, whether concurrently or sequentially (<i>p</i> > 0.05). <i>Conclusion:</i> EVE is an effective treatment option for the management of several malignancies and is often combined with other therapies, such as radiation, for a more efficient response. However, an increased risk of pulmonary fibrosis should also be anticipated when these two modalities are combined, as they both can cause pulmonary damage, especially when administered concurrently.https://www.mdpi.com/1010-660X/56/7/348radiation therapyrateverolimuspneumonitispulmonary fibrosis |
| spellingShingle | Mehmet Fuat Eren Ayfer Ay Eren Mutlay Sayan Birsen Yücel Şahende Elagöz Yıldıray Özgüven Irina Vergalasova Ahmet Altun Saadettin Kılıçkap Vasudev Daliparty Nuran Beşe The Impact of Everolimus and Radiation Therapy on Pulmonary Fibrosis Medicina radiation therapy rat everolimus pneumonitis pulmonary fibrosis |
| title | The Impact of Everolimus and Radiation Therapy on Pulmonary Fibrosis |
| title_full | The Impact of Everolimus and Radiation Therapy on Pulmonary Fibrosis |
| title_fullStr | The Impact of Everolimus and Radiation Therapy on Pulmonary Fibrosis |
| title_full_unstemmed | The Impact of Everolimus and Radiation Therapy on Pulmonary Fibrosis |
| title_short | The Impact of Everolimus and Radiation Therapy on Pulmonary Fibrosis |
| title_sort | impact of everolimus and radiation therapy on pulmonary fibrosis |
| topic | radiation therapy rat everolimus pneumonitis pulmonary fibrosis |
| url | https://www.mdpi.com/1010-660X/56/7/348 |
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