| Abstrakt: |
A woman in her late sixties had an operation for ascending colon cancer 15 months before her current admission. The pathological finding was T3(mod. SE), N0, H0, P3, M0, Stage IV. She had received chemotherapy after her operation. The first-line therapy comprised 15 courses of FOLFOX6 (from 14 to 5 months before admission). Her second-line chemotherapy comprised 6 courses of FOLFOX6+bevacizumab (BV) (from 3 to 2 months before admission). The third-line chemotherapy comprised 3 courses of FOLFIRI+BV (from 40 to 11 days before admission). She developed a high fever and respiratory failure 3 days before admission. On admission to our hospital, her chest X-ray and CT showed ground-grass opacities in bilateral lung fields. Bronchoalveolar lavage showed a predominance of lymphocytes without any evidence of infection. We diagnosed the patient as a case of lung injury caused by anticancer drugs. Steroid therapy was implemented, and her fever, respiratory failure, and chest X-ray abnormalities disappeared. Steroid therapy was stopped 6 months later and subsequently lung injury did not recur. Judging by the progress seen in this case, we concluded that her lung injury was due to irinotecan. We continued the chemotherapy for her colon cancer by prescribing S-1, it proved ineffective. The patient died from the colon cancer 27 months after her operation. |
