内容紹介
A Case of Fatal Interstitial Pneumonia during FOLFIRI plus Cetuximab Therapy for Liver Metastasis of Colon Cancer
Summary
The patient was a 76-year-old woman who underwent sigmoidectomy in April 2011 for sigmoid colon cancer with multiple concurrent liver metastases. She was treated postoperatively with mFOLFOX6 plus cetuximab but was diagnosed with the progressive disease at the end of course 14. The patient started receiving FOLFIRI plus cetuximab therapy in May 2012. Later in August 2012, she was examined for respiratory distress on the scheduled date of receiving course 7 and was diagnosed with drug-induced interstitial pneumonia resulting from systemic chemotherapy. The patient was administered oxygen, and her symptoms improved temporarily with steroid half-pulse and endotoxin adsorption therapy, but on inpatient day 10, her respiratory condition deteriorated. She was treated with steroid pulse therapy, but died of respiratory failure on inpatient day 17. The main adverse events associated with FOLFIRI plus cetuximab therapy are gastrointestinal symptoms, hematotoxicity, peripheral nerve damage, and dermatological symptoms. However, reports of respiratory conditions such as interstitial pneumonia are rare. Although the incidence is low, interstitial pneumonia can be severe and fatal and therefore requires close attention.
要旨
症例は76歳,女性。2011年4月,S状結腸癌同時性多発肝転移に対してS状結腸切除術を施行した。術後はmFOLFOX6+cetuximab療法を計14コース施行し,その後FOLFIRI+cetuximab療法を開始した。2012年8月,7コース目の予定日に呼吸苦で受診した。精査で全身化学療法による薬剤性間質性肺炎と診断され,緊急入院となった。酸素投与,ステロイドハーフパルス療法とエンドトキシン吸着療法により症状は一時的に改善したが,入院10日目に呼吸状態が増悪した。ステロイドパルス療法を施行したが,入院17日目に呼吸不全で死亡した。FOLFIRI+cetuximab療法における有害事象としての間質性肺炎の発生頻度は低いが,常に間質性肺炎の可能性を念頭に置いて治療に当たる必要があると考えられた。
目次
Summary
The patient was a 76-year-old woman who underwent sigmoidectomy in April 2011 for sigmoid colon cancer with multiple concurrent liver metastases. She was treated postoperatively with mFOLFOX6 plus cetuximab but was diagnosed with the progressive disease at the end of course 14. The patient started receiving FOLFIRI plus cetuximab therapy in May 2012. Later in August 2012, she was examined for respiratory distress on the scheduled date of receiving course 7 and was diagnosed with drug-induced interstitial pneumonia resulting from systemic chemotherapy. The patient was administered oxygen, and her symptoms improved temporarily with steroid half-pulse and endotoxin adsorption therapy, but on inpatient day 10, her respiratory condition deteriorated. She was treated with steroid pulse therapy, but died of respiratory failure on inpatient day 17. The main adverse events associated with FOLFIRI plus cetuximab therapy are gastrointestinal symptoms, hematotoxicity, peripheral nerve damage, and dermatological symptoms. However, reports of respiratory conditions such as interstitial pneumonia are rare. Although the incidence is low, interstitial pneumonia can be severe and fatal and therefore requires close attention.
要旨
症例は76歳,女性。2011年4月,S状結腸癌同時性多発肝転移に対してS状結腸切除術を施行した。術後はmFOLFOX6+cetuximab療法を計14コース施行し,その後FOLFIRI+cetuximab療法を開始した。2012年8月,7コース目の予定日に呼吸苦で受診した。精査で全身化学療法による薬剤性間質性肺炎と診断され,緊急入院となった。酸素投与,ステロイドハーフパルス療法とエンドトキシン吸着療法により症状は一時的に改善したが,入院10日目に呼吸状態が増悪した。ステロイドパルス療法を施行したが,入院17日目に呼吸不全で死亡した。FOLFIRI+cetuximab療法における有害事象としての間質性肺炎の発生頻度は低いが,常に間質性肺炎の可能性を念頭に置いて治療に当たる必要があると考えられた。