Reactions 1405 - 9 Jun 2012

★ SAntineoplastics

Oesophageal stricture (first report forifosfamide): case report

A 14-year-old boy developed oesophageal stricturefollowing antineoplastic therapy [frequencies and routesnot stated] for osteosarcoma of the left distal femur.

The boy received four courses of chemotherapy withcisplatin 167mg and doxorubicin 42mg. Despiteprophylactic therapy, he reported severe nausea andvomiting, as well as hearing impairment due to cisplatin.After the initial four courses, treatment was changed to aregimen containing etoposide 84mg, ifosfamide 4200mgand methotrexate 28mg, of which he received two courses.Five months after diagnosis, he underwent tumourresection and total knee replacement. He then received sixcourses of the second chemotherapy regimen over a5-month period. He experienced nausea and vomitingduring this time. Four weeks after the 6-coursechemotherapy, he reported dysphagia and was unable toeat solid foods [durations of treatment to reaction onset notclearly stated]. Investigation showed stricture of the distaloesophagus, with a slightly reddish and inflamed mucosa.Chemotherapy-related oesophageal stricture wasdiagnosed.

Balloon dilatation was performed over 2 months and theoesophagus diameter increased by 12mm. The boy’sdysphagia improved and he was able to ingest solid food.At last observation, the oesophagus was normal with nostrictures.

Author comment: "[I]n our case, the oesophageal strictureseems to be a result of chemotherapy."Ishimaru D, et al. Chemotherapy-induced oesophageal stricture in a child withosteosarcoma: A case report. Chemotherapy Research and Practice 2010: [3 pages],No. 240763, 2010. Available from: URL: http://dx.doi.org/10.1155/2010/240763 -Japan 803071694

» Editorial comment: A search of AdisBase, Medline andEmbase did not reveal any case reports of oesophagealstricture associated with ifosfamide. The WHO ADRdatabase contained no reports of oesophageal stenosisassociated with ifosfamide.

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Reactions 9 Jun 2012 No. 14050114-9954/10/1405-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved