Antineoplastics
1
Reactions Monitor Rapid, comprehensive identification of all adverse drug experience reports from 1700 international medical journals, presented as either summaries or citations to produce a complete file Antineoplastics First report of respiratory tract * Ij] fi stula in patients w ith locoregional aerodigestive tract cancers: 4 cases Four men, aged 52 , 48, 46 and 56 years (cases 1-4, respectively) with advanced non-metastatic squamous cell carcinoma of the oesophagus (n = 3) or lung (1) , respectively, received high dose (50-65 Gy) external beam radiotherapy, resulting in symptomatic relief for 4-20 (median 16) weeks . FollOWing locoreglonal recurrence at 18-30 (median 22) weeks, patients received palliative chemotherapy with IV cisplatin 100 mg/m 2 on day 1, and fluorouracil 40 mg/m 2 / hour as a 120- hour infusion from day 2 (n = 3) or as a 72 -hour infusion from day 2 with etoposide 80 mg/m 2 /day on days 2-4 (1) , respectively, every 3-4 weeks . Patients had a minor (n = 3) or partial (1) response to chemotherapy, respectively . After 3, 2, and 2 chemotherapy cycles, respectively, cases 1-3 presented with fever, chills and paroxysms of cough made worse when liquids were swallowed. Communication between the carcinoma and the left main bronchi al stem was shown by barium swallow. Case 1 died 1 week later with fulminant pneumonia. Celestin tubes were inserted endoscopically in cases 2 and 3. Case 2 died 2 weeks later after continued fistulisation arou nd the celestin tube. Case 3 had good palliation of symptoms , including dysphagia, and was as ymptomatic 9 months after tube placement. Case 4 developed after lower lobe pneumonia with normal blood counts after 3 chemotherapy cycles, and oesophagogram revealed multiple fistulae . Placement of celestin tube resolved clinical and radiological signs of aspiration, but the patient died 14 weeks later. The respiratory fistulae may have been caused by radiation and/or chemotherapy therefore, " , , oncologists should be aware that tumor lysis by effective chemotherapy may result In respiratory fistula' in patients with locoregion al aerodigestive cancer. Sridhar KS , Barreras L, Saldana MJ , Manten H. Cancer 61 247·251 , 15 Jan 1988 6367 4 REACTIONS'" 16 April 1988 0157-7271 / 88/ 0416-0004/ 0$01 .00/ 0 © ADIS Press
Transcript of Antineoplastics
Reactions Monitor Rapid, comprehensive identification of all adverse drug experience reports from 1700 international medical journals, presented as either summaries or citations to produce a complete file
Antineoplastics First report of respiratory tract * Ij] fistula in patients with locoregional aerodigestive tract cancers: 4 cases
Four men, aged 52, 48, 46 and 56 years (cases 1-4, respectively) with advanced non-metastatic squamous cell carcinoma of the oesophagus (n = 3) or lung (1) , respectively , received high dose (50-65 Gy) external beam radiotherapy, resulting in symptomatic relief for 4-20 (median 16) weeks. FollOWing locoreglonal recurrence at 18-30 (median 22) weeks, patients received palliative chemotherapy with IV cisplatin 100 mg/m2 on day 1, and fluorouracil 40 mg/m2/ hour as a 120-hour infusion from day 2 (n = 3) or as a 72-hour infusion from day 2 with etoposide 80 mg/m2/day on days 2-4 (1) , respectively , every 3-4 weeks. Patients had a minor (n = 3) or partial (1) response to chemotherapy, respectively .
After 3, 2, and 2 chemotherapy cycles, respectively , cases 1-3 presented with fever, chills and paroxysms of cough made worse when liquids were swallowed . Communication between the carcinoma and the left main bronchial stem was shown by barium swallow. Case 1 died 1 week later with fulminant pneumonia. Celestin tubes were inserted endoscopically in cases 2 and 3. Case 2 died 2 weeks later after continued fistulisation around the celestin tube. Case 3 had good palliation of symptoms , including dysphagia, and was asymptomatic 9 months after tube placement.
Case 4 developed after lower lobe pneumonia with normal blood counts after 3 chemotherapy cycles, and oesophagogram revealed multiple fistulae . Placement of celestin tube resolved clinical and radiological signs of aspiration , but the patient died 14 weeks later.
The respiratory fistulae may have been caused by radiation and/or chemotherapy therefore, " , , oncologists should be aware that tumor lysis by effective chemotherapy may result In respiratory fistula' in patients with locoregional aerodigestive cancer. Sridhar KS, Barreras L, Saldana MJ, Manten H. Cancer 61 247·251 , 15 Jan 1988 6367
4 REACTIONS'" 16 April 1988 0157-7271 / 88/ 0416-0004/ 0$01 .00/ 0 © ADIS Press
