厄洛替尼联合全脑放疗非小细胞肺癌脑转移患者头部皮肤回忆反应探究  

Radiation recall dermatitis induced by erlotinib in patient with brain metastases

作　　者：王威 申戈[2] 吴世凯[2] 董大鹏[2] 郝瑞敏[2] 孙慧茹[2] 周明[2] 周仕香[2] 杨刚[2] 王钦文[2] 孙冰[2] 宋三泰[2] 

机构地区：[1]北京丰台区长峰医院肿瘤科,北京100039 [2]军事医学科学院附属医院肿瘤中心,北京100071

出　　处：《中国医学装备》2014年第2期90-92,共3页China Medical Equipment

摘　　要：目的:探讨全脑放射治疗后服用厄洛替尼引起的头部皮肤放射治疗回忆反应。方法:对右肺腺癌(T3N2M1)骨转移患者行全脑放疗,DT:40 Gy,20次,4周。放疗结束后即开始服用厄洛替尼150 mg/d。结果:服用厄洛替尼第21 d,开始出现头部皮疹、毛囊炎及局部感染,并逐渐加重,按RTOG急性反应标准评为3级;皮肤严重反应界线与全脑放疗范围一致。停用厄洛替尼,对症处理5 d后明显好转,考虑为厄洛替尼引起的放射治疗回忆反应。结论:放射治疗后服用厄洛替尼有可能引起回忆反应,程度严重时需减量或停药,并积极对症治疗。Objective： Radiation recall dermatitis （RRD） occurs in a previously irradiated field and is triggered by certain cytotoxic drugs or target drugs. A case of RRD caused by treatment with erlotinib 21 days after whole brain radiation therapy （WBRT） is reported. PATIENT AND Methods： A 56-year-old female patient with boon metastase of non-small cell lung cancer （T3N2M1） was found brain metases in MRI without symptom 3 months after diagnosis. She was treated with WBRT （Dt40Gy/20f/4weeks） and erlotinib （150mg/day） thereafter. Results：The patient developed rash, folliculitis and localized infection in her head skin 21 days after the first dose of erlotinib （grade 3 Radiation Therapy Oncology Group scoring criteria）. The severity lesions were localized to head skin which limited in scope of WBRT. Erlotinib was stop and treatment to lesions was applied. The diagnosis of RDD induced by erlotinib was made. Conclusion：The use of Erlotinib after RT may trigger RRD. We advise clinicians to be cautious of RRD after erlotinib treatment. The drug should be unused and the treatment to severity lesions should be applied.

关 键 词：厄洛替尼 放疗 回忆反应 脑转移 

分 类 号：R734.2[医药卫生—肿瘤]