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Particle Beam Therapy Tolerance and Outcome on Patients with Autoimmune Diseases: A Single Institution Matched Case–Control Study

SIMPLE SUMMARY: The decision to offer radiation therapy for cancer in patients with autoimmune diseases is problematic, due to the possibility that such diseases can predispose patients to higher acute and late treatment toxicity by triggering a pro-inflammatory cascade. Specifically, no data are av...

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Autores principales: Riva, Giulia, Vischioni, Barbara, Gandini, Sara, Cavalieri, Stefano, Ronchi, Sara, Barcellini, Amelia, Bonora, Maria, Chalaszczyk, Agnieszka, Ingargiola, Rossana, Vitolo, Viviana, Fiore, Maria Rosaria, Iannalfi, Alberto, Orlandi, Ester
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8534022/
https://www.ncbi.nlm.nih.gov/pubmed/34680331
http://dx.doi.org/10.3390/cancers13205183
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author Riva, Giulia
Vischioni, Barbara
Gandini, Sara
Cavalieri, Stefano
Ronchi, Sara
Barcellini, Amelia
Bonora, Maria
Chalaszczyk, Agnieszka
Ingargiola, Rossana
Vitolo, Viviana
Fiore, Maria Rosaria
Iannalfi, Alberto
Orlandi, Ester
author_facet Riva, Giulia
Vischioni, Barbara
Gandini, Sara
Cavalieri, Stefano
Ronchi, Sara
Barcellini, Amelia
Bonora, Maria
Chalaszczyk, Agnieszka
Ingargiola, Rossana
Vitolo, Viviana
Fiore, Maria Rosaria
Iannalfi, Alberto
Orlandi, Ester
author_sort Riva, Giulia
collection PubMed
description SIMPLE SUMMARY: The decision to offer radiation therapy for cancer in patients with autoimmune diseases is problematic, due to the possibility that such diseases can predispose patients to higher acute and late treatment toxicity by triggering a pro-inflammatory cascade. Specifically, no data are available regarding the impact of this problem on particle therapy. Although the number of patients who access particle therapy is lower than photon treatment, and despite the fact that autoimmune diseases are not a frequent comorbidity in the population, our study reports an increase in terms of acute G3 toxicity in patients with autoimmune diseases compared to a control group without ADs. Since no severe G4–G5 events were reported and in consideration of the benefit of particle therapy for selected cancers, we conclude that article therapy should be not discouraged for patients with autoimmune conditions. ABSTRACT: It is unclear whether autoimmune diseases (ADs) may predispose patients to higher radiation-induced toxicity, and no data are available regarding particle therapy. Our objective was to determine if cancer patients with ADs have a higher incidence of complications after protons (PT) or carbon ion (CIRT) therapy. METHODS. In our retrospective monocentric study, 38 patients with ADs over 1829 patients were treated with particle therapy between 2011 and 2020. Thirteen patients had collagen vascular disease (CVD), five an inflammatory bowel disease (IBD) and twenty patients an organ-specific AD. Each patient was matched with two control patients without ADs on the basis of type/site of cancer, type of particle treatment, age, sex, hypertension and/or diabetes and previous surgery. RESULTS. No G4–5 complications were reported. In the AD group, the frequency of acute grade 3 (G3) toxicity was higher than in the control group (15.8% vs. 2.6%, p = 0.016). Compared to their matched controls, CVD–IBD patients had a higher frequency of G3 acute complications (27.7 vs. 2.6%, p = 0.002). There was no difference between AD patients (7.9%) and controls (2.6%) experiencing late G3 toxicity (p = 0.33). The 2 years disease-free survival was lower in AD patients than in controls (74% vs. 91%, p = 0.01), although the differences in terms of survival were not significant. CONCLUSIONS. G3 acute toxicity was more frequently reported in AD patients after PT or CIRT. Since no severe G4–G5 events were reported and in consideration of the benefit of particle therapy for selected cancers, we conclude that particle therapy should be not discouraged for patients with ADs. Further prospective studies are warranted to gain insight into toxicity in cancer patients with ADs enrolled for particle therapy.
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spelling pubmed-85340222021-10-23 Particle Beam Therapy Tolerance and Outcome on Patients with Autoimmune Diseases: A Single Institution Matched Case–Control Study Riva, Giulia Vischioni, Barbara Gandini, Sara Cavalieri, Stefano Ronchi, Sara Barcellini, Amelia Bonora, Maria Chalaszczyk, Agnieszka Ingargiola, Rossana Vitolo, Viviana Fiore, Maria Rosaria Iannalfi, Alberto Orlandi, Ester Cancers (Basel) Article SIMPLE SUMMARY: The decision to offer radiation therapy for cancer in patients with autoimmune diseases is problematic, due to the possibility that such diseases can predispose patients to higher acute and late treatment toxicity by triggering a pro-inflammatory cascade. Specifically, no data are available regarding the impact of this problem on particle therapy. Although the number of patients who access particle therapy is lower than photon treatment, and despite the fact that autoimmune diseases are not a frequent comorbidity in the population, our study reports an increase in terms of acute G3 toxicity in patients with autoimmune diseases compared to a control group without ADs. Since no severe G4–G5 events were reported and in consideration of the benefit of particle therapy for selected cancers, we conclude that article therapy should be not discouraged for patients with autoimmune conditions. ABSTRACT: It is unclear whether autoimmune diseases (ADs) may predispose patients to higher radiation-induced toxicity, and no data are available regarding particle therapy. Our objective was to determine if cancer patients with ADs have a higher incidence of complications after protons (PT) or carbon ion (CIRT) therapy. METHODS. In our retrospective monocentric study, 38 patients with ADs over 1829 patients were treated with particle therapy between 2011 and 2020. Thirteen patients had collagen vascular disease (CVD), five an inflammatory bowel disease (IBD) and twenty patients an organ-specific AD. Each patient was matched with two control patients without ADs on the basis of type/site of cancer, type of particle treatment, age, sex, hypertension and/or diabetes and previous surgery. RESULTS. No G4–5 complications were reported. In the AD group, the frequency of acute grade 3 (G3) toxicity was higher than in the control group (15.8% vs. 2.6%, p = 0.016). Compared to their matched controls, CVD–IBD patients had a higher frequency of G3 acute complications (27.7 vs. 2.6%, p = 0.002). There was no difference between AD patients (7.9%) and controls (2.6%) experiencing late G3 toxicity (p = 0.33). The 2 years disease-free survival was lower in AD patients than in controls (74% vs. 91%, p = 0.01), although the differences in terms of survival were not significant. CONCLUSIONS. G3 acute toxicity was more frequently reported in AD patients after PT or CIRT. Since no severe G4–G5 events were reported and in consideration of the benefit of particle therapy for selected cancers, we conclude that particle therapy should be not discouraged for patients with ADs. Further prospective studies are warranted to gain insight into toxicity in cancer patients with ADs enrolled for particle therapy. MDPI 2021-10-15 /pmc/articles/PMC8534022/ /pubmed/34680331 http://dx.doi.org/10.3390/cancers13205183 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Riva, Giulia
Vischioni, Barbara
Gandini, Sara
Cavalieri, Stefano
Ronchi, Sara
Barcellini, Amelia
Bonora, Maria
Chalaszczyk, Agnieszka
Ingargiola, Rossana
Vitolo, Viviana
Fiore, Maria Rosaria
Iannalfi, Alberto
Orlandi, Ester
Particle Beam Therapy Tolerance and Outcome on Patients with Autoimmune Diseases: A Single Institution Matched Case–Control Study
title Particle Beam Therapy Tolerance and Outcome on Patients with Autoimmune Diseases: A Single Institution Matched Case–Control Study
title_full Particle Beam Therapy Tolerance and Outcome on Patients with Autoimmune Diseases: A Single Institution Matched Case–Control Study
title_fullStr Particle Beam Therapy Tolerance and Outcome on Patients with Autoimmune Diseases: A Single Institution Matched Case–Control Study
title_full_unstemmed Particle Beam Therapy Tolerance and Outcome on Patients with Autoimmune Diseases: A Single Institution Matched Case–Control Study
title_short Particle Beam Therapy Tolerance and Outcome on Patients with Autoimmune Diseases: A Single Institution Matched Case–Control Study
title_sort particle beam therapy tolerance and outcome on patients with autoimmune diseases: a single institution matched case–control study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8534022/
https://www.ncbi.nlm.nih.gov/pubmed/34680331
http://dx.doi.org/10.3390/cancers13205183
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