Doxorubicin liposomal
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Oral squamous cell carcinoma: 5 case reports Five women, aged 52–76 years, developed oral squamous cell carcinoma (SCC) during treatment with doxorubicin liposomal for recurrent ovarian cancer [route not stated]. A 76-year-old woman developed SCC of her tongue. It was staged as T1N0M0. She had been receiving doxorubicin liposomal for 96 months at 6–8 week intervals with a cumulative dose of 1800 mg/m2. Doxorubicin liposomal was discontinued and she received radiotherapy but this was stopped early due to painful mucositis. She underwent glossectomy after recurrence at the original tumour site. She died at the age of 77 years after being hospitalised for a presumptive cardiac event. A 67-year-old woman received a cumulative dose of doxorubicin liposomal of 2320 mg/m2. She had been taking the drug for 132 months and developed tongue pain and a whitish patch of sublingual thickening. Biopsy showed dysplasia. Complete excision was carried out and doxorubicin liposomal was discontinued. At last follow-up, she was alive with no evidence of suspicious tongue lesions or ovarian cancer. A 52-year-old woman developed multifocal oral SCC. She started treatment with monthly doxorubicin liposomal in August 2002. Carboplatin was added in 2004 for four cycles. Thereafter, she received doxorubicin liposomal 30 mg/m2 every 5–6 weeks until late 2009 when she reported oral pain. The cumulative doxorubicin liposomal dose was 3000 mg/m2 and the duration of treatment at the time of SCC diagnosis was 80 months. Doxorubicin liposomal was discontinued and she underwent resection of three separate SCC lesions in February 2010. She began postoperative radiation but recurrence and new nodal disease developed. She received chemotherapy but in October 2011 she developed hypercalcaemia and marked growth of a recurrent neck mass. She died from an acute airway obstruction. A 71-year-old woman was diagnosed with SCC stage T2N0 after having received doxorubicin liposomal for 32 months. She received doxorubicin liposomal and carboplatin for four cycles in early 2006 and began doxorubicin liposomal monotherapy from May 2006. The cumulative dose was 2116 mg/m2. Doxorubicin liposomal was discontinued and she underwent partial glossectomy. At last follow-up, she was alive with no evidence of SCC recurrence. A 54-year-old woman developed a gingival sore which was diagnosed as SCC stage T1N0. She had started doxorubicin liposomal 30 mg/m2 in 2007 and received it every 4 weeks for three cycles in combination with carboplatin. She was then placed on doxorubicin liposomal 30 mg/m2 maintenance therapy until April 2010. The cumulative dose was 1696 mg/m2 and the duration of treatment was 30 months. She developed her gingival sore 18 months after stopping doxorubicin liposomal. Surgical excision was performed. At last follow-up, her ovarian cancer had progressed. Author comment: "Awareness of this possible long-term complication during [doxorubicin liposomal] treatment should enhance the likelihood of early detection of oral lesions in these patients." Cann
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