Antineoplastics

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Reactions 1145 - 31 Mar 2007 Antineoplastics Thrombosis with concomitant radiotherapy: case report A 25-year-old woman developed an internal carotid artery thrombosis after antineoplastic treatment and radiotherapy for Hodgkin’s disease. The woman completed eight weekly cycles of bleomycin, doxorubicin, dacarbazine and vinblastine [dosages not stated] and achieved partial remission of the disease. She completed an additional eight antineoplastic cycles; however, residual disease was still evident. Three weeks later, she underwent involved radiotherapy of 30 Gy on the mediastinum up to the carotid bifurcation and an additional 6 Gy only on the mediastinum. Seven months after chemoradiotherapy, she reported two episodes of blindness in her left eye, which lasted for a few minutes. Duplex ultrasounds of the left internal carotid artery revealed a calcified intimal wall thickness with a hypoechogenic thrombus determining partial lumen obstruction. The woman received aspirin and atorvastatin and, after she experienced another episode of blindness, she also received clopidogrel. At latest follow-up, she had experienced no further episodes of blindness and serial ultrasound of her left internal carotid artery revealed the vessel wall and arterial blood flow had returned to normal. Author comment: "An endothelial dysfunction or a direct activation of the coagulation cascade by the chemoradiotherapy treatment may have resulted in the formation of a thrombus in the irradiated area." Di Nisio M, et al. Endothelial damage of the internal carotid artery after chemoradiotherapy of the neck for a Hodgkin lymphoma. Thrombosis and Haemostasis 97: 315-316, No. 2, Feb 2007 - Italy 801070265 1 Reactions 31 Mar 2007 No. 1145 0114-9954/10/1145-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved

Transcript of Antineoplastics

Page 1: Antineoplastics

Reactions 1145 - 31 Mar 2007

Antineoplastics

Thrombosis with concomitant radiotherapy: casereport

A 25-year-old woman developed an internal carotid arterythrombosis after antineoplastic treatment and radiotherapy forHodgkin’s disease.

The woman completed eight weekly cycles of bleomycin,doxorubicin, dacarbazine and vinblastine [dosages not stated]and achieved partial remission of the disease. She completedan additional eight antineoplastic cycles; however, residualdisease was still evident. Three weeks later, she underwentinvolved radiotherapy of 30 Gy on the mediastinum up to thecarotid bifurcation and an additional 6 Gy only on themediastinum. Seven months after chemoradiotherapy, shereported two episodes of blindness in her left eye, whichlasted for a few minutes. Duplex ultrasounds of the left internalcarotid artery revealed a calcified intimal wall thickness with ahypoechogenic thrombus determining partial lumenobstruction.

The woman received aspirin and atorvastatin and, after sheexperienced another episode of blindness, she also receivedclopidogrel. At latest follow-up, she had experienced nofurther episodes of blindness and serial ultrasound of her leftinternal carotid artery revealed the vessel wall and arterialblood flow had returned to normal.

Author comment: "An endothelial dysfunction or a directactivation of the coagulation cascade by thechemoradiotherapy treatment may have resulted in theformation of a thrombus in the irradiated area."Di Nisio M, et al. Endothelial damage of the internal carotid artery afterchemoradiotherapy of the neck for a Hodgkin lymphoma. Thrombosis andHaemostasis 97: 315-316, No. 2, Feb 2007 - Italy 801070265

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Reactions 31 Mar 2007 No. 11450114-9954/10/1145-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved