Pulmonary Fibrosis Secondary to Oxaliplatin Treatment: From Rarity to Reality: A Case Study and Literature Review
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COMMENTARY
Pulmonary Fibrosis Secondary to Oxaliplatin Treatment: From Rarity to Reality: A Case Study and Literature Review Ana C. Moreira . Joa˜o Portela . Carlos Couto . Jose´ Duarte . Nata´lia Martins
. Jorge Soares
Received: June 9, 2020 Ó The Author(s) 2020
ABSTRACT Oxaliplatin-based chemotherapy has been widely used to treat colorectal cancer. Here, we report a case of a 71-year-old man, former smoker (40 pack-years), with no history of relevant exposures such as occupational, environmental or drug exposure. The patient developed acute partial respiratory insufficiency concomitant with the eighth cycle of adjuvant chemotherapy with oxaliplatin and capecitabine for stage IIIA colorectal adenocarcinoma. After the exclusion of other causes, namely pulmonary thromboembolism, high-resolution chest computed tomography (CT) showed a Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12827312. A. C. Moreira (&) J. Portela C. Couto J. Duarte J. Soares Pulmonology Department, Hospital Garcia de Orta, Almada, Lisbon, Portugal e-mail: [email protected] N. Martins Pulmonology Department, Centro Hospitalar Universita´rio de Sa˜o Joa˜o, Porto, Portugal N. Martins Department of Medicine, Faculty of Medicine, University of Porto, Porto, Portugal N. Martins Institute for Research and Innovation in Health (i3S), University of Porto, Porto, Portugal
usual interstitial pneumonia (UIP) pattern. After the discussion at the multidisciplinary meeting on interstitial lung diseases and considering the temporal association between clinical and imaging findings and chemotherapy treatment, along with exclusion of other potential causes, the most likely hypothesis was pulmonary fibrosis secondary to oxaliplatin. A literature review on this scope was also performed. We conclude that pulmonary fibrosis is a rare complication of oxaliplatin, but with the widespread use of oxaliplatin combinations in colorectal cancer, active assessment for interstitial lung disease is recommended.
Keywords: Interstitial lung disease; Oxaliplatin; Respiratory insufficiency; Toxicity
Oncol Ther
Key Summary Points Oxaliplatin and capecitabine combination has become a well-established cancer treatment. When used as monotherapy or adjuvant to surgery, several toxicities have been reported. Acute pulmonary toxicity is a very rare side effect, and the true incidence is unknown. Data on oxaliplatin-induced acute pulmonary toxicity were reviewed and a case presented.
DIGITAL FEATURES This article is published with digital features to facilitate understanding of the article. To view digital features for this article go to https://doi. org/10.6084/m9.figshare.12827312.
INTRODUCTION The introduction of oxaliplatin, a third-generation platinum drug, as part of treatment in metastatic colorectal carcinoma occurred about 20 years ago in metastatic and adjuvant settings [1–3]. In addition, the combination of oxaliplatin and capecitabine has become a wellestablished treatment as monotherapy or as a
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