Takeda Yasushige, Kubota Tetsushi, Choda Yasuhiro, Toi Yoichiro, Ichimura Koichi, Ishida Michihiro, Yano Takuya, Sato Daisuke, Yoshimitsu Masanori, Nakano Kanyu, Harano Masao, Matsukawa Hiroyoshi, Idani Hitoshi, Shiozaki Shigehiro, Okajima Masazumi
Dept. of Surgery, Hiroshima City Hiroshima Citizens Hospital.
Gan To Kagaku Ryoho. 2021 Jan;48(1):154-156.
Case 1: A 51-year-old man with advanced gastric cancer and peritoneal metastasis was referred to our hospital. He received fourth-line chemotherapy with nivolumab, but it became PD. Next, he received S-1 plus docetaxel therapy as fifth- line therapy. After 2 courses of S-1 plus docetaxel, erythema and blisters appeared on his limbs, with erosions of the oral mucosa and penis. We diagnosed Stevens-Johnson syndrome(SJS)based on the clinical and pathological findings. He received steroid treatment, but the cutaneous symptoms persisted; therefore, it was impossible to continue the chemotherapy because of the SJS. Case 2: A 75-year-old woman with recurrence of peritoneally disseminated gastric cancer received third-line chemotherapy with nivolumab. After 1 course of nivolumab, erythema appeared on her body and limbs, with erosion of the lips and oral mucosa. We diagnosed SJS based on the clinical findings. She received steroid treatment, but the cutaneous symptoms persisted; therefore, it was impossible to continue chemotherapy because of the SJS. It should be noted that the onset of serious irAEs, such as SJS, might make continuous chemotherapy difficult.
病例1：一名51岁患有晚期胃癌伴腹膜转移的男性患者被转诊至我院。他接受了纳武单抗的四线化疗，但疾病进展。接下来，他接受了S-1联合多西他赛作为五线治疗。在进行2个疗程的S-1联合多西他赛后，他的四肢出现红斑和水疱，口腔黏膜和阴茎有糜烂。基于临床和病理表现，我们诊断为史蒂文斯-约翰逊综合征（SJS）。他接受了类固醇治疗，但皮肤症状持续存在；因此，由于SJS无法继续化疗。病例2：一名75岁腹膜播散性胃癌复发的女性患者接受了纳武单抗的三线化疗。在进行1个疗程的纳武单抗治疗后，她的身体和四肢出现红斑，嘴唇和口腔黏膜有糜烂。基于临床发现，我们诊断为SJS。她接受了类固醇治疗，但皮肤症状持续存在；因此，由于SJS无法继续化疗。需要注意的是，诸如SJS等严重免疫相关不良反应的发生可能会使持续化疗变得困难。
