Reactions 1187 - 2 Feb 2008

★ SAntineoplastics

Nasopharyngeal stenosis (first report withcapecitabine, cisplatin and doxorubicin): 2 casereports

A 43-year-old woman and a 64-year-old man developednasopharyngeal stenosis (NPS) during chemoradiation therapyfor advanced nasopharyngeal cancer.

The woman received two cycles of chemotherapy withcapecitabine, cisplatin and paclitaxel followed by radiotherapyand two adjuvant cycles of paclitaxel and cisplatin [dosagesand duration of treatments not stated]. The man received threecycles of chemotherapy with cisplatin, doxorubicin andpaclitaxel, followed by radiotherapy; one cycle ofchemotherapy with cisplatin and docetaxel was administeredat the start and at the end of radiotherapy [dosages andduration of treatments not stated]. About 3 months after theirradiotherapy, both patients developed severely compromisednasal breathing, hyponasal speech and apnoeic episodes; theyalso complained of daytime somnolence. Findings from headand neck examinations, including nasal and oral endoscopy,were consistent with type III NPS; stenoses were high and noscarring was visible from the mouth.

Both patients underwent surgical implantation ofnasopharyngeal silastic stents. Postoperatively, they receivedantibacterials and proton pump inhibitors; they weredischarged on postoperative day 1. Stents were removed after6 months with complete resolution of obstructive symptoms.Stenosis had resolved and nasal airways were patent 5 monthsafter stent removal in the woman, and 2 months after stentremoval in the man.Baptista P, et al. Acquired nasopharyngeal stenosis: surgical treatment for thisunusual complication after chemoradiation for nasopharyngeal carcinoma.Otolaryngology - Head and Neck Surgery 137: 959-961, No. 6, Dec 2007 -Spain 801079821

» Editorial comment: A search of AdisBase, Medline andEmbase did not reveal any previous case reports ofnasopharyngeal stenosis associated with capecitabine, cisplatinor doxorubicin. The WHO Adverse Drug Reactions databasecontained no reports of pharyngeal disorders associated withdoxorubicin or capecitabine, but two reports of pharyngealdisorders associated with cisplatin.

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Reactions 2 Feb 2008 No. 11870114-9954/10/1187-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved