Ito Tadao, Deguchi Katsuya, Yoshii Kazuhiro, Kashii Mariko
Dept. of Surgery, Rakuwakai Marutamachi Hospital.
Gan To Kagaku Ryoho. 2017 Jul;44(7):599-602.
A 73-year-old woman diagnosed with unresectable pancreatic cancer received weekly gemcitabine(GEM)plus albuminbound paclitaxel(nab-PTX)therapy. Four months after nab-PTX therapy was initiated, she presented with a rapidly decreasing vision in her left eye at an ophthalmology clinic. On admission, her visual acuity was decreased, and optical coherence tomography(OCT)revealed a cystoid macular edema(CME)only in her left eye. She discontinued the nab-PTX therapy immediately. Her visual acuity improved on follow-up 6 months later. The CME finding on OCT was reduced but not completely resolved. CME is a rare adverse event induced by nab-PTX therapy, with only 14 cases reported since 2008. In most of the reported cases, the patients had breast cancer, and this is the first reported case of CME in a patient with pancreatic cancer. The time to CME onset from starting nab-PTX therapy was reported to range from3 to 30months, but the predilection time has not been clarified. Many reports indicated that symptoms improved in a short period after discontinuation of nab-PTX therapy, but effective treatment was not established, except discontinuation of nab-PTX therapy. In daily medical treatment, the incongruity of the ophthalmologic domain should be confirmed for early detection of CME.
一名73岁被诊断为不可切除胰腺癌的女性接受了每周一次的吉西他滨(GEM)联合白蛋白结合型紫杉醇(nab-PTX)治疗。在开始nab-PTX治疗四个月后,她在眼科诊所出现左眼视力迅速下降。入院时,她的视力下降,光学相干断层扫描(OCT)显示仅左眼有黄斑囊样水肿(CME)。她立即停止了nab-PTX治疗。6个月后的随访中她的视力有所改善。OCT上的CME表现有所减轻但未完全消退。CME是nab-PTX治疗引起的罕见不良事件,自2008年以来仅报告了14例。在大多数报告病例中,患者患有乳腺癌,这是首例胰腺癌患者发生CME的报告病例。据报道,从开始nab-PTX治疗到发生CME的时间为3至30个月,但偏好时间尚未明确。许多报告表明,在停止nab-PTX治疗后的短时间内症状有所改善,但除了停止nab-PTX治疗外,尚未确立有效的治疗方法。在日常医疗中,应确认眼科领域的不一致情况以便早期发现CME。