Division of Hematology-Oncology, Department of Medicine, Taipei Veterans General Hospital, No.201, Sec. 2, Shih-Pai Road, Taipei 112, Taiwan.
Jpn J Clin Oncol. 2011 Feb;41(2):269-71. doi: 10.1093/jjco/hyq195. Epub 2010 Oct 28.
Bevacizumab added to 5-fluorouracil-based chemotherapy can improve outcomes in patients with metastatic colorectal cancer. Bevacizumab had several notable adverse effects including bowel perforation but pneumothorax had never been reported in the available English literature. We reported a 45-year-old male with lung metastases from colorectal cancer who had spontaneous pneumothorax after the second cycle of bevacizumab-containing chemotherapy. His pneumothorax resolved after tube thoracostomy with a small caliber catheter. The mechanism of pneumothorax developed after bevacizumab therapy was not clear as bowel perforation but tumor necrosis with ruptured parietal pleura might be the cause. In patients who had chest discomfort after bevacizumab-containing therapy, pneumothorax should never be overlooked as one of the differential diagnoses.
贝伐珠单抗联合氟尿嘧啶类化疗可改善转移性结直肠癌患者的预后。贝伐珠单抗有几个显著的不良反应，包括肠穿孔，但气胸在现有的英文文献中从未报道过。我们报告了一例 45 岁的男性，患有结直肠癌肺转移，在接受贝伐珠单抗联合化疗的第二周期后发生自发性气胸。他的气胸在经皮细导管胸腔引流后得到缓解。气胸发生在贝伐珠单抗治疗后的机制尚不清楚，可能是肠穿孔，但肿瘤坏死伴壁层胸膜破裂导致。在接受贝伐珠单抗治疗后出现胸痛的患者中，气胸绝不能被忽视为鉴别诊断之一。
