Docetaxel-induced fluid retention during adjuvant chemotherapy with S-1 plus docetaxel
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CASE REPORT
Docetaxel‑induced fluid retention during adjuvant chemotherapy with S‑1 plus docetaxel Kunihiro Tsuji1 · Yosuke Kito1 · Saori Miyajima1 · Miwa Yonezawa2 · Anna Kubo2 · Kahori Ushijima2 · Hisashi Doyama1 Received: 3 June 2020 / Accepted: 5 October 2020 © Japanese Society of Gastroenterology 2020
Abstract S-1 plus docetaxel is the standard postoperative adjuvant chemotherapy regimen for patients with stage III gastric cancer in Japan, which has increased the use of docetaxel. One of the most common adverse events of docetaxel, which is widely used to treat several malignancies, is fluid retention. Conversely, the most worrisome cause of ascites in patients who receive adjuvant chemotherapy is recurrence. Sometimes, the differential diagnosis of ascites is difficult if ascitic cytology is negative. In this study, we presented the case of a patient with massive ascites that appeared during adjuvant chemotherapy with S-1 plus docetaxel. Keywords Fluid retention · Docetaxel · Gastric cancer · Ascites · SAAG
Introduction Gastric cancer is the fifth most common cancer and third leading cause of cancer-related death globally [1]. The only curative treatment for gastric cancer is surgical resection. However, patients with gastric cancer have a risk of recurrence after tumor resection. A pivotal phase III trial found that S-1 in the adjuvant setting was superior to surgery alone for patients who had undergone curative D2 gastrectomy for stage II or III gastric cancer [2]. Furthermore, another pivotal phase III trial reported the superiority of S-1 plus docetaxel over S-1 alone as adjuvant chemotherapy for patients with stage III gastric cancer [3]. Therefore, this combination regimen is recognized as the standard postoperative adjuvant chemotherapy regimen for patients with stage III gastric cancer in Japan. Docetaxel belongs to the taxane drug class of anti-microtubule agents used to treat several types of cancer including * Kunihiro Tsuji [email protected] 1
Department of Gastroenterology, Ishikawa Prefectural Central Hospital, 2‑1 Kuratukihigashi, Kanazawa, Ishikawa 920‑8530, Japan
Department of Pharmacy, Ishikawa Prefectural Central Hospital, 2‑1 Kuratukihigashi, Kanazawa, Ishikawa 920‑8530, Japan
2
gastric cancer. Docetaxel has exhibited promising activity both as monotherapy and in combination with other agents. The common adverse effects of this drug include neutropenia, anemia, thrombocytopenia, neuropathy, alopecia, hypersensitivity, and fluid retention [4]. Fluid retention presents as swelling of the extremities, pleural effusions, and ascites. The severity of docetaxel-induced fluid retention is proportional to the cumulative drug dose [5]. The most common cause of ascites in patients with gastric cancer who received postoperative adjuvant chemotherapy is recurrence. In this study, we presented a case of massive ascites that appeared in a patient receiving adjuvant chemotherapy with S-1 plus docetaxel after D2 gastrectomy.
Case report A 67-year-old man diagnosed with gastric cancer u
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