Department of Medical Oncology, The Canberra Hospital, Canberra, Australian Capital Territory, Australia
ANU Medical School, Australian National University, Canberra, Australian Capital Territory, Australia.
BMJ Case Rep. 2020 May 20;13(5):e235005. doi: 10.1136/bcr-2020-235005.
Cisplatin is a widely used chemotherapeutic agent for many cancer types. Its toxicity profile includes drug-induced vascular damage. Clinicians should be aware of its varied presentation, including acute and chronic vascular events involving the arterial and venous system. This is a case of an otherwise well 32-year-old man with testicular cancer who received bleomycin/etoposide/cisplatin, and presented following two cycles of chemotherapy with homonymous hemianopia secondary to acute stroke. Acute arterial complications are rare, but clinicians should maintain a high index of suspicion for such events, even in a patient who otherwise has no vascular risk factors. Primary and secondary prevention measures including lifestyle modifications (smoking cessation, diet and exercise), blood pressure and cholesterol management, and antiplatelet therapy should be considered in patients exposed to cisplatin, during and following their treatment.
顺铂是一种广泛用于多种癌症类型的化疗药物。其毒性特征包括药物引起的血管损伤。临床医生应了解其各种表现,包括涉及动脉和静脉系统的急性和慢性血管事件。这是一例患有睾丸癌的 32 岁健康男性,接受了博来霉素/依托泊苷/顺铂治疗,在接受两个周期的化疗后出现了急性中风引起的同源性偏盲。急性动脉并发症较为罕见,但临床医生即使在没有血管危险因素的患者中也应高度怀疑此类事件。对于接受顺铂治疗的患者,应考虑包括生活方式改变(戒烟、饮食和运动)、血压和胆固醇管理以及抗血小板治疗在内的一级和二级预防措施,包括在治疗期间和治疗后。