Tamura Takashi, Tamura Shinobu, Nasu Hideki, Fujimoto Tokuzo, Kinoshita Takahiro
Department of Internal Medicine, Social Insurance Kinan Hospital.
Nihon Kokyuki Gakkai Zasshi. 2011 Sep;49(9):702-6.
The patient was a 70-year-old woman. She was admitted to our hospital complaining of fever and dyspnea. Chest CT scan showed a 50 x 30-mm tumorous shadow in S6 of the left lung and honeycomb lung in both lower lobes. As the result of cytodiagnosis with ultrasonic echo, adenocarcinoma was diagnosed. Clinical stage was IIIA (T3N2M0). We selected carboplatin and paclitaxel with bevacizumab as first-line chemotherapy, but at 7 days after the initiating it, the chest X-ray showed left pneumothorax. A chest drainage tube was placed in the left thoracic cavity. The patient was treated repeatedly pleurodesis with minocycline and OK-432. The pneumothorax required 3 weeks to cure. We selected carboplatin and paclitaxel without bevacizumab for the second course, and the pneumothorax did not recur. Pneumothorax was a serious adverse event associated with bevacizumab-containing chemotherapy. It is necessary to be aware of the possibility of pneumothorax when we treat lung adenocarcinoma with bevacizumab-containing chemotherapy.
该患者为一名70岁女性。她因发热和呼吸困难入院。胸部CT扫描显示左肺S6区有一个50×30毫米的肿瘤阴影，双下叶有蜂窝肺。经超声回声细胞诊断，确诊为腺癌。临床分期为IIIA期（T3N2M0）。我们选择卡铂、紫杉醇联合贝伐单抗作为一线化疗方案，但在开始化疗7天后，胸部X线显示左侧气胸。在左胸腔置入了胸腔引流管。患者用米诺环素和OK-432反复进行胸膜固定术治疗。气胸需要3周才能治愈。第二疗程我们选择了不含贝伐单抗的卡铂和紫杉醇，气胸未复发。气胸是含贝伐单抗化疗相关的严重不良事件。在用含贝伐单抗的化疗方案治疗肺腺癌时，有必要意识到气胸的可能性。
