Read William L, Mortimer Joanne E, Picus Joel
Department of Medicine, Division of Medical Oncology at Washington University, St. Louis, Missouri, USA.
Cancer. 2002 Feb 1;94(3):847-53. doi: 10.1002/cncr.10263.
Interstitial pneumonitis has not been reported as a toxicity of docetaxel. The authors report the presentation and natural history of four patients who developed a severe interstitial pneumonitis after receiving docetaxel.
The hospital and outpatient records of patients treated with docetaxel were reviewed to identify whether any of these patients required an evaluation for respiratory problems.
Four patients developed an interstitial pneumonitis that could be explained only as a toxicity of docetaxel. None had metastatic disease to the lung, and all had normal liver function before receiving chemotherapy. The patients presented with acute dyspnea and fever within 1-2 weeks of receiving docetaxel. All developed progressive interstitial infiltrates and respiratory failure that required mechanical ventilation. An exhaustive workup for other causes of pneumonitis was negative. Broad-spectrum antibiotics and corticosteroids were ineffective. Two patients died of complications related to the pulmonary process. The two survivors required ventilatory support for more than 21 days. The clinical and pathologic findings of these patients are presented.
Interstitial pneumonitis is a rare and potentially fatal complication of docetaxel treatment. Prolonged ventilatory support is appropriate in patients with a favorable prognosis.
间质性肺炎尚未被报道为多西他赛的一种毒性反应。作者报告了4例在接受多西他赛后发生严重间质性肺炎的患者的临床表现及疾病自然史。
回顾接受多西他赛治疗患者的住院及门诊记录，以确定这些患者中是否有任何人需要针对呼吸问题进行评估。
4例患者发生了间质性肺炎，只能解释为多西他赛的毒性反应。所有患者肺部均无转移病灶，且在接受化疗前肝功能均正常。患者在接受多西他赛后1 - 2周内出现急性呼吸困难和发热。所有患者均出现进行性间质浸润和呼吸衰竭，需要机械通气。对肺炎的其他病因进行的全面检查均为阴性。广谱抗生素和皮质类固醇治疗无效。2例患者死于与肺部病变相关的并发症。2例幸存者需要通气支持超过21天。本文展示了这些患者的临床和病理表现。
间质性肺炎是多西他赛治疗罕见且可能致命的并发症。对于预后良好的患者，延长通气支持是合适的。
