Tayer-Shifman Oshrat E, Rottenberg Yakir, Shuvy Mony
Department of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Tumori. 2009 Jul-Aug;95(4):547-9. doi: 10.1177/030089160909500427.
The superior toxicity profile is one of the major reasons for the widespread use of gemcitabine in cancer treatment. Bone marrow suppression is the most common side effect, while non-hematological events are relatively infrequent. Cardiac toxicity is a rare complication and cardiac arrhythmia is even rarer. We report the case of a 67-year-old woman with metastatic breast cancer without a history of cardiac arrhythmia or ischemic heart disease who developed supraventricular tachycardia. The symptoms had started immediately after gemcitabine treatment. The arrhythmia responded poorly to common treatment and was eventually controlled by oral propranolol five days after admission. The present case suggests that supraventricular tachycardia may be triggered by gemcitabine even without underlying significant heart disease and may be resistant to conventional therapy.
较高的毒性谱是吉西他滨在癌症治疗中广泛应用的主要原因之一。骨髓抑制是最常见的副作用，而非血液学事件相对较少见。心脏毒性是一种罕见的并发症，心律失常则更为罕见。我们报告了一例67岁转移性乳腺癌女性患者，该患者无心律失常或缺血性心脏病病史，却发生了室上性心动过速。症状在吉西他滨治疗后立即出现。心律失常对常规治疗反应不佳，入院五天后最终通过口服普萘洛尔得到控制。本病例表明，即使没有潜在的严重心脏病，吉西他滨也可能引发室上性心动过速，且可能对传统治疗有抵抗性。
