Intersticial pneumonitis after oxaliplatin treatment in colorectal cancer

Hernández-Yagüe, X.; Soy, Ester; Merino, Bernardo Queralt; Puig, Jordi; Fabregat, Miguel Beltrán; Colomer, Ramón

doi:10.1007/bf02717006

Cited by 45 publications

(28 citation statements)

References 10 publications

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“…Most cases of pulmonary toxicity associated to oxaliplatin reported in the literature had a rapid and untoward course [8,9,11], similar to what occurred in our patients. It is not known whether prior interstitial lung damage or impairment in respiratory function tests may make development of oxaliplatin-induced interstitial pneumonitis more likely [11].…”

Section: Discussionsupporting

confidence: 86%

“…Since oxaliplatin was marketed and became widely used in clinical practice, not many data suggesting pulmonary toxicity have been documented, though there have been some reports of isolated cases of patients treated with oxaliplatin in whom respiratory insufficiency associated to pulmonary infiltrates evolving to pulmonary fibrosis was found [6,[8][9][10][11]. No other causative factor of respiratory insufficiency could be found in these patients, and the condition was therefore attributed to oxaliplatin.…”

Section: Discussionmentioning

confidence: 95%

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Fatal pneumonitis induced by oxaliplatin

et al. 2008

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 95%

Fatal pneumonitis induced by oxaliplatin

et al. 2008

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“…Oxaliplatin has been associated with adverse effects in the upper respiratory tract, mainly pharyngolaryngeal discomfort and inspiratory stridor [10]. One case of interstitial pneumonitis has recently been related to oxaliplatin administration preceded by one cycle of 5-FU in a patient with colorectal cancer [6]. Recently, a case of eosinophilic lung disease after treatment with oxaliplatin and 5-FU/folinic acid was reported [11].…”

Section: Discussionmentioning

confidence: 99%

“…Recognized side effects implicate myelosuppression, nausea/vomiting and neuropathies, mainly paresthesia and dysesthesia of hands, feet and the perioral region [2]; acute pulmonary toxicity has only been described in very few reports [5,6,7]. …”

Section: Introductionmentioning

confidence: 99%

Pulmonary Fibrosis after Chemotherapy with Oxaliplatin and 5-Fluorouracil for Colorectal Cancer

Mundt¹,

Mochmann²,

Ebhardt³

et al. 2007

Oncology

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Background: Chemotherapy with oxaliplatin and 5-fluorouracil (5-FU)/folinic acid is the standard first-line therapy of metastatic colorectal carcinoma and has shown activity in several other malignancies. This regimen is mostly well tolerated. Known side effects include myelosuppression, nausea/vomiting and neuropathies; acute pulmonary toxicity has only been described in very few reports. Case Report: A 66-year-old male with metastatic rectal adenocarcinoma treated with 12 cycles of oxaliplatin and 5-FU/folinic acid developed bilateral pulmonary infiltrates and respiratory failure. Broad-spectrum antibiotic therapy did not improve his condition and extended microbiological diagnostics did not show an infectious etiology. Therapy with corticosteroids led to a short improvement, however the patient died 1 week after the initiation of corticosteroid treatment due to respiratory insufficiency. The clinical and histopathological data as well as the lack of an infectious cause indicate that pulmonary fibrosis was induced by oxaliplatin and 5-FU/folinic acid. Conclusion: This case demonstrates that treatment with oxaliplatin and 5-FU/folinic acid can cause acute pulmonary fibrosis. Even though pulmonary toxicity is rare in patients treated with this chemotherapy regimen compared to infectious pulmonary complications, it should be considered early in the clinical course of otherwise unexplained pulmonary infiltrates hopefully leading to a better outcome.

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“…There are ground-glass opacities with superimposed reticulation in the right lung imply that 5-fl uorouracil/leucovorin alone was not responsible for the development of FOLFOX-induced interstitial pneumonia in these patients. In 2005, Yagues and colleagues 11 fi rst reported a case of interstitial pneumonia induced by oxaliplatin alone. Taken together, the above observations suggest that oxaliplatin, alone or in combination with 5-fl uorouracil/leucovorin, contributes to the development of FOLFOX-induced interstitial pneumonia.…”

Section: Figmentioning

confidence: 98%

Interstitial pneumonia arising in a patient treated with oxaliplatin, 5-fluorouracil, and, leucovorin (FOLFOX)

et al. 2009

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Information concerning the pulmonary toxicity of oxaliplatin with infusional 5-fluorouracil plus leucovorin (FOLFOX) is very limited. We herein report the case of a patient with FOLFOX-induced interstitial pneumonia. An 82-year-old man with unresectable colon cancer liver metastases was referred to our department for chemotherapy with the FOLFOX protocol. After the administration of ten cycles, he visited our outpatient clinic with a 2-week history of coughing and shortness of breath; he was afebrile. A chest radiograph showed reticular shadows with ground-glass opacities mainly involving the middle and lower zones of the right lung. Computed tomography depicted ground-glass opacities with superimposed reticulation in the right lung. A diagnosis of FOLFOX-induced interstitial pneumonia was made based on the clinical course and imaging findings. The symptoms disappeared within 3 days after the cessation of the FOLFOX regimen and the initiation of high-dose corticosteroid treatment. Two months after the initiation of the corticosteroid treatment, complete remission of the radiological abnormalities was confirmed; thereafter, interstitial pneumonia did not recur despite the reintroduction of 5-fluorouracil/leucovorin alone, suggesting that 5-fluorouracil/leucovorin alone was not responsible for the development of the interstitial pneumonia. Thus, oxaliplatin, alone or in combination with 5-fluorouracil/leucovorin, may have caused the interstitial pneumonia in this patient. Once interstitial pneumonia has occurred, cessation of the regimen is mandatory, and high-dose corticosteroid treatment is commonly given to rescue patients from this potentially lethal complication.

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Intersticial pneumonitis after oxaliplatin treatment in colorectal cancer

Cited by 45 publications

References 10 publications

Fatal pneumonitis induced by oxaliplatin

Fatal pneumonitis induced by oxaliplatin

Pulmonary Fibrosis after Chemotherapy with Oxaliplatin and 5-Fluorouracil for Colorectal Cancer

Interstitial pneumonia arising in a patient treated with oxaliplatin, 5-fluorouracil, and, leucovorin (FOLFOX)

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