Radiation hepatitis after postmastectomy radiation therapy for early breast cancer: difficult to differentiate from drug-induced liver injury caused by abemaciclib.

IF 0.5 Q4 ONCOLOGY

International Cancer Conference Journal Pub Date : 2024-08-19 eCollection Date: 2024-10-01 DOI:10.1007/s13691-024-00714-1

Shogo Nakamoto, Takahiro Waki, Asuka Mimata, Takahiro Tsukioki, Yuko Takahashi, Yoko Iwatani, Tsuguo Iwatani, Tadahiko Shien

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Abstract

Abemaciclib (ABM) is recommended for adjuvant endocrine therapy in hormone receptor-positive, human epidermal growth factor receptor type 2-negative early breast cancer (EBC) patients at high risk of recurrence. Here, we present a case of radiation hepatitis challenging to differentiate from drug-induced liver injury during ABM treatment. The patient, a woman in her 40 s, underwent right mastectomy, axillary dissection, and postmastectomy radiation therapy (PMRT) after neoadjuvant chemotherapy for EBC. Subsequently, she received ABM as adjuvant endocrine therapy. Despite suspending ABM due to Grade 3 leukopenia, she developed Grade 3 hepatic dysfunction upon cessation. Based on the dynamic contrast-enhanced computed tomography, we diagnosed the cause of liver dysfunction as radiation hepatitis. Spontaneous improvement allowed us to resume ABM treatment. Clinicians may need to consider radiation hepatitis as a potential cause of hepatic dysfunction in patients who underwent PMRT, along with drug-induced liver injury.

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早期乳腺癌乳房切除术后放射治疗后的放射性肝炎：难以与阿贝昔单抗导致的药物性肝损伤区分开来。

对于激素受体阳性、人类表皮生长因子受体 2 型阴性、复发风险较高的早期乳腺癌（EBC）患者，推荐使用阿贝美克利布（ABM）进行辅助内分泌治疗。在此，我们介绍了一例在 ABM 治疗过程中难以与药物引起的肝损伤相鉴别的放射性肝炎病例。患者是一名 40 多岁的女性，在接受新辅助化疗治疗 EBC 后，接受了右侧乳房切除术、腋窝清扫术和乳房切除术后放疗（PMRT）。随后，她接受了 ABM 作为辅助内分泌治疗。尽管由于白细胞减少达到 3 级而暂停了 ABM，但在停止治疗后她又出现了 3 级肝功能异常。根据动态对比增强计算机断层扫描，我们诊断肝功能异常的原因是放射性肝炎。患者病情的自发改善使我们得以恢复 ABM 治疗。临床医生可能需要将放射性肝炎与药物性肝损伤一起视为导致接受 PMRT 患者肝功能异常的潜在原因。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Cancer Conference Journal ONCOLOGY-

自引率

14.30%

发文量

期刊介绍： This online-only journal publishes original case reports on all types of cancer. In particular, we welcome not only case reports of educational value in the diagnosis and treatment of cancers, but also reports on molecularly analyzed cancer cases, including gene mutations, gene fusions, gene expression, and changes in copy number, regardless of their known clinical significance. Assessing the molecular analysis of a tumor usually requires a “cancer conference” in which experts from various fields discuss it. Even if the authors and their respective “cancer conference” were unable to determine the clinical significance of molecular changes at the time of submission and publication, their data may provide evidence that will help the scientific community develop precision medicine solutions in the future. We welcome case reports with reviews of the literature on similar cases, as they are more useful and valuable to readers than are reports of rare cases. International Cancer Conference Journal is the official publication of the Japan Society of Clinical Oncology (JSCO). - Presents an online-only collection of original case reports on all types of cancer - In particular, welcomes molecularly analyzed cancer cases - The Official Publication of the Japan Society of Clinical Oncology (JSCO)