Tufts Medical Center, Boston, MA 02111, USA.
Anticancer Res. 2012 Sep;32(9):4147-9.
Gemcitabine is the only approved cytotoxic agent for the treatment of pancreatic cancer by the Food and Drug Administration. In addition, gemcitabine is also commonly used for the management of breast, ovarian, and non-small cell lung cancer. Myelosuppression is the most common toxicity of gemcitabine therapy. Pulmonary toxicities due to gemcitabine have, however, been reported. Dyspnea occurs in approximately 25% of patients treated with gemcitabine, whereas serious pulmonary toxicities are much less common, approximately 0.3%. Here, we present a case of gemcitabine-induced pneumonitis, encountered during treatment of pancreatic cancer, and review the literature of this rare, but dangerous complication.
A 56-year old male being treated for stage IV pancreatic cancer developed progressive dyspnea on exertion, chest tightness, and palpitations. Oxygen saturation was 82-84%. Computerized-tomography (CT) angiography of the chest demonstrated new diffuse groundglass opacities in the bilateral lower lobes when compared to the CT of the chest without intravenous contrast, 5 weeks prior. Mild to moderate emphysema was also seen, but no pulmonary emboli were detected. Myocardial infraction was ruled-out by normal electrocardiogram and normal cardiac biomarkers.
We report another case of gemcitabine-induced pneumonitis. Physicians seeing such patients should be aware of this rare but real pulmonary toxicity. A delay in diagnosis and treatment can lead to potentially fatal outcomes.
吉西他滨是食品和药物管理局唯一批准用于治疗胰腺癌的细胞毒性药物。此外，吉西他滨也常用于治疗乳腺癌、卵巢癌和非小细胞肺癌。骨髓抑制是吉西他滨治疗最常见的毒性。然而，已有吉西他滨引起的肺毒性的报道。大约 25%接受吉西他滨治疗的患者出现呼吸困难，而严重的肺毒性则更为少见，约为 0.3%。在此，我们报告了一例吉西他滨诱导性肺炎，在治疗胰腺癌时发生，并复习了这种罕见但危险的并发症的文献。
一名 56 岁男性，因 IV 期胰腺癌接受治疗，出现进行性活动后呼吸困难、胸闷和心悸。血氧饱和度为 82-84%。与 5 周前未行静脉对比的胸部 CT 相比，胸部 CT 血管造影显示双侧下叶出现新的弥漫性磨玻璃影。还可见轻度至中度肺气肿，但未发现肺栓塞。正常心电图和正常心脏标志物排除了心肌梗死。
我们报告了另一个吉西他滨诱导性肺炎的病例。遇到此类患者的医生应该意识到这种罕见但真实的肺部毒性。诊断和治疗的延误可能导致潜在的致命后果。
