Hettiarachchi Sanjeewa Malinda, Thilakaratne Dilanka, Dharmasena Dawpadee, Rathnapala Amila, Abeysinghe Prasad, Perera Eshanth
National Hospital for Respiratory Diseases Welisara Sri Lanka.
National Hospital Kandy Sri Lanka.
Respirol Case Rep. 2021 Jun 13;9(7):e00802. doi: 10.1002/rcr2.802. eCollection 2021 Jul.
Taxane-induced pneumotoxicity is rare. However, 1-5% of patients taking docetaxel may develop severe pneumotoxicity. This has been limited to case reports in the literature. We report seven breast cancer patients who developed docetaxel-induced diffuse parenchymal lung disease (DPLD) of an organizing pneumonia pattern on high-resolution computed tomography (HRCT). The patients presented with progressive breathlessness within four weeks of the final dose. All had an organizing pneumonia pattern on their HRCTs, without other evidence of infection. Restrictive lung disease with low carbon monoxide diffusing capacity (DLCO) was noted, with desaturation on a 6-min walk test (6MWT). They were started on prednisolone. Repeated HRCT after four to eight weeks from the commencement of steroid treatment showed marked improvement. The clinical and functional improvement were also significant. One patient succumbed to the illness as a result of severe lung involvement. Docetaxel-induced DPLD is a fatal adverse effect, which can be managed by the cessation of the drug and starting on steroids in adequate doses.
紫杉烷诱导的肺毒性很罕见。然而，接受多西他赛治疗的患者中有1% - 5%可能会发生严重的肺毒性。这在文献中仅限于病例报告。我们报告了7例乳腺癌患者，这些患者在高分辨率计算机断层扫描（HRCT）上出现了多西他赛诱导的以机化性肺炎为特征的弥漫性实质性肺疾病（DPLD）。患者在最后一剂药物后的四周内出现进行性呼吸困难。所有患者的HRCT均显示有机化性肺炎的表现，无其他感染证据。观察到存在一氧化碳弥散量（DLCO）降低的限制性肺疾病，6分钟步行试验（6MWT）时有血氧饱和度下降。他们开始使用泼尼松龙治疗。从开始使用类固醇治疗后的四至八周重复进行HRCT检查显示有明显改善。临床和功能改善也很显著。1例患者因严重的肺部受累而死亡。多西他赛诱导的DPLD是一种致命的不良反应，可通过停药并开始使用足量类固醇进行治疗。
