Department of Medical Oncology, UZ Brussel, Brussels, Belgium.
Anticancer Res. 2014 Mar;34(3):1179-82.
Pemetrexed (Alimta™) is a frequently used multi-targeted antifolate drug for the treatment of inoperable and metastatic non-squamous cell lung cancer and mesothelioma, administered as a single-agent or in combination with platinum analogs. In some patients, radiotherapy to any part of the body precedes administration of pemetrexed. This drug has been associated with hematological toxicity and cutaneous side-effects. Most skin toxicities are benign, mainly presenting as a diffuse rash and occurring shortly after treatment. In the present case report we present a rare cutaneous side-effect namely radiation recall dermatitis. A grade 2 dermatitis strongly mimicking mastitis of the breast was observed in a patient treated with a second cycle of single-agent pemetrexed, used as maintenance treatment post-induction chemotherapy with cisplatin and pemetrexed for newly-diagnosed non-squamous cell lung cancer. Fifteen years earlier, the patient had undergone irradiation of the whole breast after breast-conserving surgery. In previously published cases, there were initial symptoms of pain, dysesthesia or burning sensation in the previously-irradiated skin area after the initial pemetrexed administration in the absence of visible cutaneous signs. Although this was not the case for our patient, such symptoms should alert physicians to subsequent potentially more severe clinical dermatitis if the drug is continued. Prevention studies are required to overcome this rare but potentially severe side-effect.
培美曲塞（力比泰）是一种常用于治疗不可切除和转移性非鳞状细胞肺癌和间皮瘤的多靶点抗叶酸药物，可作为单药或与铂类似物联合使用。在某些患者中，全身任何部位的放射治疗都先于培美曲塞的给药。该药物与血液毒性和皮肤副作用有关。大多数皮肤毒性是良性的，主要表现为弥漫性皮疹，并且在治疗后不久发生。在本病例报告中，我们报告了一种罕见的皮肤副作用，即放射回忆性皮炎。在接受顺铂和培美曲塞诱导化疗后，作为新诊断的非鳞状细胞肺癌的维持治疗，接受第二周期单药培美曲塞治疗的患者中观察到 2 级皮炎，强烈模仿乳腺炎。15 年前，该患者在保乳手术后接受了全乳房照射。在以前发表的病例中，在首次培美曲塞给药后，在没有可见皮肤迹象的情况下，在先前照射的皮肤区域出现最初的疼痛、感觉异常或烧灼感等初始症状。虽然我们的患者没有这种情况，但如果继续使用该药物，这些症状应该提醒医生注意随后可能更严重的临床性皮炎。需要进行预防研究以克服这种罕见但潜在严重的副作用。
