Wang Connor, Rose Stephen, Mankowski Gettle Lori, Spencer Ryan
Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA.
Division of Gynecologic Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA.
Case Rep Obstet Gynecol. 2020 Feb 7;2020:4629452. doi: 10.1155/2020/4629452. eCollection 2020.
Gemcitabine and docetaxel combination chemotherapy is the standard of care for patients with unresectable recurrent or metastatic leiomyosarcoma of the uterus. Although they are generally well-tolerated agents, they can also cause severe and life-threatening pulmonary toxicities. Here, we describe a case of grade 4 pneumonitis due to gemcitabine and docetaxel in a 74-year-old woman with recurrent, metastatic uterine leiomyosarcoma. Despite early recognition of chemotherapy-induced lung injury and early administration of corticosteroid, she developed noncardiogenic pulmonary edema, diffuse alveolar hemorrhage, and acute respiratory distress syndrome. She required multiple intubations and a tracheostomy. Physicians should not only be aware of gemcitabine and docetaxel's potential to cause life-threatening pulmonary injuries but also recognize the variability in clinical presentations and treatment responses, the radiographic findings of these lung toxicities, and the need for early corticosteroid therapy in these cases.
吉西他滨与多西他赛联合化疗是无法切除的复发性或转移性子宫平滑肌肉瘤患者的标准治疗方案。尽管它们通常是耐受性良好的药物，但也会引起严重的、危及生命的肺部毒性。在此，我们描述了一名74岁复发性、转移性子宫平滑肌肉瘤女性患者因吉西他滨和多西他赛导致4级肺炎的病例。尽管早期识别出化疗引起的肺损伤并早期给予了皮质类固醇治疗，但她仍出现了非心源性肺水肿、弥漫性肺泡出血和急性呼吸窘迫综合征。她需要多次插管和气管切开术。医生不仅应意识到吉西他滨和多西他赛有导致危及生命的肺部损伤的可能性，还应认识到临床表现和治疗反应的变异性、这些肺部毒性的影像学表现以及在这些病例中早期使用皮质类固醇治疗的必要性。
