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子宫内膜原发性小细胞癌术后多西他赛与铂类联合化疗后双侧失明伴继发性视网膜色素变性:一例罕见病例报告及文献复习

Bilateral blindness with secondary retinitis pigmentosa following postoperative docetaxel and platinum combination chemotherapy in primary small-cell carcinoma of the endometrium: An unusual case report and review of the literature.

作者信息

Tang Qiong-Lan, Liu Jia, Zuo Li, Chi Cong, Dong Hui-Yu, Jiang Xiao-Xia, Jiang Xue-Feng

机构信息

Department of Pathology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510120, P.R. China.

Department of Obstetrics and Gynecology, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong 510630, P.R. China.

出版信息

Mol Clin Oncol. 2017 Apr;6(4):477-482. doi: 10.3892/mco.2017.1174. Epub 2017 Feb 24.

Abstract

Ocular toxicity is an uncommon complication of cytotoxic chemotherapy. Bilateral blindness with secondary retinitis pigmentosa (RP) following docetaxel and platinum combination chemotherapy at the recommended dose is extremely rare. The present study reports a case of advanced small-cell carcinoma (SCC) of the endometrium in a patient with diabetes mellitus type 2. The patient suffered from RP with a sharp decline in vision after the fourth course of postoperative docetaxel and platinum combination chemotherapy. Unfortunately, the patient developed bilateral blindness after another course of chemotherapy at a reduced dose. No tumor recurrence was observed during the 33 months of follow-up. A total of 35 cases of docetaxel- and/or platinum-induced retinal toxicity were found in the English literature and reviewed. The ischemic and electrophysiological hypotheses may have been implicated in the pathogenesis of ocular toxicity in the present case, particularly with the history of diabetes. Understanding the ocular side effects of this combination chemotherapy may assist gynecological oncologists and ophthalmologists with early recognition and timely intervention before blindness is established.

摘要

眼部毒性是细胞毒性化疗一种不常见的并发症。按照推荐剂量使用多西他赛和铂类联合化疗后出现双侧失明并继发视网膜色素变性(RP)的情况极为罕见。本研究报告了1例2型糖尿病患者发生晚期子宫内膜小细胞癌(SCC)的病例。该患者在术后接受第4个疗程的多西他赛和铂类联合化疗后出现RP且视力急剧下降。不幸的是,该患者在接受另一个较低剂量疗程的化疗后出现双侧失明。在33个月的随访期间未观察到肿瘤复发。在英文文献中检索并回顾了总共35例多西他赛和/或铂类引起的视网膜毒性病例。缺血和电生理假说可能与本例眼部毒性的发病机制有关,尤其是结合糖尿病病史来看。了解这种联合化疗的眼部副作用可能有助于妇科肿瘤学家和眼科医生在失明形成之前进行早期识别和及时干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d45/5374963/92dfb775b69c/mco-06-04-0477-g00.jpg

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