Irinotecan-related Pulmonary Toxicity-A Case Report

化學治療相關的肺毒性－病例報告

10.29806/TM.200608.0006

陳耿彬(Geeng-Bin Chen)；李勁毅(Ching-Yi Lee)；陳國勳(Kuo-Shuen Chen)；吳子卿(Tzu-Chin Wu)；吳銘芳(Ming-Fang Wu)

irinotecan ； 食道癌 ； 肺毒性 ； 肺炎 ； 急性呼吸窘迫症候群 ； irinotecan ； esophageal cancer ； pulmonary toxicity ； pneumonitis ； acute respiratory distress syndrome

胸腔醫學

21卷4期（2006 / 08 / 01）

343 - 348

英文

Irinotecan是一個廣泛應用於大腸直腸、胃、肺及食道惡性腫瘤的化學治療藥物。我們報告一位55歲晚期食道癌男性病人，在接受三個irinotecan療程後，產生進行性肺部浸潤和呼吸衰竭。在日本最初的研究，雖然經驗性使用類固醇，病人仍然因進行性肺部浸潤和呼吸衰竭而死亡。由於irinotecan臨床使用適應症增加，我們描述irinotecan相關肺毒性。有肺部疾病的病人可能會有較高的危險。醫師應對這種可能性保持警覺。

Irinotecan is a widely used chemotherapeutic agent for colorectal, gastric, lung, and esophageal cancer. We present the case a 55-year-old man with advanced esophageal cancer who developed progressive interstitial lung infiltrates and who suffered respiratory failure following 3 courses of irinotecan. Progressive pulmonary insufficiency and death were also reported in the initial Japanese studies, despite the institution of empiric steroid therapy for a syndrome similar to that which our patient experienced. As the clinical indications for the use of irinotecan are expanding, we would like to emphasize that irinotecan-associated pulmonary toxicity is a potentially serious adverse effect. Patients with pre-existing pulmonary disease may be at higher risk for this complication, and clinicians should be alert to this possibility.