Docetaxel-induced interstitial lung disease among patients with breast cancer: a case series and review of literature.

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.