Cisplatin
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Toxicity syndrome: 11 case reports In a retrospective study of 125 patients with locally advanced head-and-neck cancer (LAHNC) treated radically from January 2013 to June 2017, 11 patients (4 women and 7 men) aged 37–75 years were described, who developed toxicity syndrome including mucositis-dysphagia-aspiration-sepsis (MDAS) complex, sepsis, chest infection, febrile neutropenia or neutropenia during chemotherapy with cisplatin for LAHNC [routes and durations of treatments to reactions onsets not stated]. The patients, who had LAHNC stage III, IVA or IVB at oropharynx (4 patients), hypopharynx (4 patients), external auditory canal (1 patient), cervical lymph nodes with unknown primary (1 patient) and oral cavity (1 patient), started receiving chemotherapy with cisplatin 40 mg/m2 per week for 1–6 cycles (7 patients) and 100 mg/m2 per 3 weeks for 1–3 cycles (4 patients). Thereafter, the patients also received concurrent radiotherapy. Subsequently, the patients developed toxicity syndrome including MDAS complex (9 patients), and febrile neutropenia and sepsis (2 patients). Additionally, of these 11 patients, four patients developed neutropenia and one patient developed neutropenia and chest infection. Of the 11 patients, eight patients had persistent cough, and nine patients had weight loss of 1–6kgs. The patients with MDAS had mucositis for >2–8 weeks and dysphagia for >2–16 weeks. The mucositis was of grade 4 in one of the 9 patients with MDAS. The patients also developed thromboembolism (1 patient), diabetic ketoacidosis (1 patient) and wound dehiscence (1 patient). In five of the 11 patients, one patient had multiple day-care admissions for IV hydration and was fed via nasogastric tube; one patient had multiple day-care admissions and 3 patients had multiple day-care admissions and in-patient admissions. Around 1–12 weeks after receiving radiotherapy, the patients died due to toxicity syndrome with MDAS complex (9 patients), and febrile neutropenia and sepsis (2 patients). Muzumder S, et al. Toxicity syndrome and early competing deaths in head-and-neck cancer undergoing radiation therapy: Observation and hypothesis. Medical Hypotheses 803506708 143: Oct 2020. Available from: URL: http://doi.org/10.1016/j.mehy.2020.110145
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Reactions 17 Oct 2020 No. 1826
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