Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan; Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan.
Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan; Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan.
Explore (NY). 2021 May-Jun;17(3):236-238. doi: 10.1016/j.explore.2020.08.014. Epub 2020 Aug 28.
Anaplastic astrocytoma has a dismal prognosis with conventional treatment. Multidisciplinary treatment is needed to control the disease; however, side effects of the treatment reduce a patient's quality of life (QOL). Carmustine-impregnated wafers (Gliadel®, Eisai Co., Ltd., Tokyo, Japan), one of the treatment modalities for anaplastic astrocytoma, has been reported to have drug-induced fever as a side effect.
A 36-year-old man underwent excision for a recurrent brain tumor. Histopathological examination established a diagnosis of anaplastic astrocytoma and an intracranial carmustine implant was placed for local chemotherapy. Postoperatively, the patient developed high fever, which could not be controlled using antipyretics. The high fever ameliorated dramatically after the administration of Kampo medicines, specifically orengedokuto and shosaikoto, and the patient could continue chemotherapy.
To the best of our knowledge, this is the first report of successful treatment of intractable carmustine implant-induced fever using Kampo medicine. In this case, Kampo medicine led to an improvement of QOL.
传统治疗方法对于间变性星形细胞瘤预后极差。需要多学科治疗来控制疾病，但治疗的副作用会降低患者的生活质量（QOL）。卡莫司汀植入剂（Gliadel ® ，卫材株式会社，东京，日本）是治疗间变性星形细胞瘤的一种方法，有报道称其会引起药物热等副作用。
一名 36 岁男性因复发性脑肿瘤接受了切除术。组织病理学检查确诊为间变性星形细胞瘤，并进行颅内卡莫司汀植入以进行局部化疗。术后，患者出现高热，解热药无法控制。在使用汉方药治疗后，高热明显改善，具体为或然德古托和小柴胡汤，且患者能够继续化疗。
据我们所知，这是首例使用汉方药成功治疗难治性卡莫司汀植入物引起的发热的报告。在本例中，汉方药改善了生活质量。
