Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
Chemotherapy. 2012;58(1):84-8. doi: 10.1159/000336131. Epub 2012 Feb 23.
Pneumonitis after pemetrexed has been rarely reported in conjunction with radiation therapy.
Two cases of pemetrexed-induced pneumonitis in different clinical settings and with unequal outcomes are discussed with a review of the literature.
Two patients with stage IIIB non-small cell lung cancer developed interstitial lung disease after chemotherapy with pemetrexed. The first patient was previously treated with thoracic radiotherapy, and radiation pneumonitis was initially suspected. He died shortly after pemetrexed reexposition. The second patient developed pemetrexed-induced interstitial lung disease despite no prior radiotherapy. After discontinuation of pemetrexed and administration of steroids, pneumonitis resolved completely.
Interstitial lung disease is a rare but potentially fatal side effect of pemetrexed. It occurs more often after radiotherapy but can also be encountered in the absence of radiotherapy. Reexposition to pemetrexed may lead to severe interstitial lung disease and even death and should be strictly avoided.
培美曲塞联合放射治疗后发生肺炎的情况非常罕见。
讨论了两种不同临床情况下发生的培美曲塞诱导性肺炎病例，以及对文献的回顾。
两名 IIIB 期非小细胞肺癌患者在接受培美曲塞化疗后发生间质性肺病。第一位患者曾接受过胸部放射治疗，最初怀疑为放射性肺炎。培美曲塞再暴露后不久他就去世了。第二位患者尽管没有接受过放射治疗，但也发生了培美曲塞诱导的间质性肺病。培美曲塞停用和类固醇治疗后，肺炎完全缓解。
间质性肺病是培美曲塞罕见但潜在致命的副作用。它在放射治疗后更常见，但也可在没有放射治疗的情况下发生。再次接触培美曲塞可能导致严重的间质性肺病甚至死亡，应严格避免。
