头颈部癌症患者因西妥昔单抗联合米诺环素而发生中毒性表皮坏死松解症。

Toxic epidermal necrolysis caused by cetuximab plus minocycline in head and neck cancer.

机构信息

Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.

出版信息

Am J Otolaryngol. 2010 Jul-Aug;31(4):288-90. doi: 10.1016/j.amjoto.2009.02.021. Epub 2009 Jun 3.

DOI:10.1016/j.amjoto.2009.02.021

PMID:20015761

Abstract

We present a unique case of toxic epidermal necrolysis (TEN) caused by cetuximab plus minocycline during chemoradiation for recurrent squamous cell carcinoma of the head and neck (SCCHN). In April 2008, a 49-year-old man was diagnosed with recurrent SCCHN. He received surgery and postoperative adjuvant therapy with cetuximab plus chemoradiation. Because of exacerbation of acneform rash by cetuximab, minocycline was added thereafter. However, TEN appeared after the fifth course of weekly cetuximab, and cetuximab plus minocycline was assumed to be the cause. Cetuximab plus minocycline carries a risk of evoking TEN, and the side effects of chemoradiation for SCCHN mask some early signs of TEN. Noticing the transformation of skin lesions makes early diagnosis possible, and prompt cessation of the causative agent is essential for patients with TEN. We review the literature on cetuximab, minocycline, and TEN and discuss the impact of TEN on cancer therapy.

摘要

我们报告了一例由西妥昔单抗联合米诺环素引起的中毒性表皮坏死松解症（TEN）的病例，该患者在接受头颈部复发性鳞状细胞癌（SCCHN）的放化疗期间发生了该病例。2008 年 4 月，一名 49 岁男性被诊断为复发性 SCCHN。他接受了手术，并在术后接受了西妥昔单抗联合放化疗的辅助治疗。由于西妥昔单抗引起痤疮样皮疹恶化，此后加用了米诺环素。然而，在第五次每周西妥昔单抗治疗后出现了 TEN，故推测西妥昔单抗联合米诺环素是导致 TEN 的原因。西妥昔单抗联合米诺环素有引发 TEN 的风险，而 SCCHN 的放化疗的副作用掩盖了 TEN 的一些早期迹象。注意皮肤损伤的变化可实现早期诊断，对 TEN 患者而言，及时停止使用致病药物至关重要。我们回顾了关于西妥昔单抗、米诺环素和 TEN 的文献，并讨论了 TEN 对癌症治疗的影响。