Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
J Infect Chemother. 2010 Oct;16(5):340-4. doi: 10.1007/s10156-010-0058-4. Epub 2010 Mar 31.
Interstitial pneumonitis has sporadically been reported as a toxic effect of taxanes such as docetaxel and paclitaxel. This report describes 2 patients who developed interstitial pneumonitis after receiving chemotherapy including taxanes, and both cases grew serious enough to require respiratory support. The first case was a 57-year-old man with gastric cancer treated with docetaxel biweekly and S-1 for 2 weeks as adjuvant chemotherapy. After 4 courses of docetaxel, he presented acute dyspnea. The second case was a 66-year-old woman with breast cancer and postoperative pleural recurrence treated with weekly paclitaxel as fourth-line chemotherapy. She developed a dry cough, high fever, and dyspnea after 1 course of paclitaxel. In both cases, computed tomography (CT) showed extensive bilateral areas of ground-glass attenuation. They developed progressive interstitial infiltrates and respiratory failure that required mechanical ventilation. Taxane-induced interstitial pneumonitis was diagnosed to exclude other causes. From previous reports, intubation is associated with the survival of patients with taxane-induced interstitial pneumonitis. However, corticosteroid therapy was dramatically effective and resolved the interstitial pneumonitis in both our patients. Clinicians should be aware of this occasional complication during the course of chemotherapy with taxanes and initiate treatment, including respiratory support, as soon as possible.
间质性肺炎偶尔被报道为紫杉醇类药物（如多西他赛和紫杉醇）的毒性作用。本报告描述了 2 例接受包括紫杉醇类药物在内的化疗后发生间质性肺炎的患者，这 2 例患者均发展为严重的呼吸支持依赖。第 1 例为 57 岁男性，胃癌患者，接受多西他赛每 2 周 1 次和 S-1 治疗 2 周作为辅助化疗。在接受 4 个疗程的多西他赛后，他出现了急性呼吸困难。第 2 例为 66 岁女性，乳腺癌患者，术后胸膜复发，接受每周紫杉醇作为四线化疗。在接受 1 个疗程紫杉醇后，她出现干咳、高热和呼吸困难。在这 2 例患者中，计算机断层扫描（CT）显示广泛的双侧磨玻璃影。他们出现了进行性间质浸润和呼吸衰竭，需要机械通气。诊断为紫杉醇引起的间质性肺炎以排除其他原因。根据以往的报告，气管插管与紫杉醇引起的间质性肺炎患者的生存有关。然而，皮质类固醇治疗效果显著，解决了我们患者的间质性肺炎。临床医生在接受紫杉醇类药物化疗过程中应注意这种偶发的并发症，并尽快开始治疗，包括呼吸支持。
