Neutropenic enterocolitis in an advanced epithelial ovarian cancer patient treated with paclitaxel/platinum-based chemotherapy: a case report and review of the literature.
Neutropenic enterocolitis in an advanced epithelial ovarian cancer patient treated with paclitaxel/platinum-based chemotherapy: a case report and review of the literature.
复制标题
接受紫杉醇/铂类化疗的晚期上皮性卵巢癌患者的中性粒细胞减少性小肠结肠炎：病例报告和文献综述。
作者：
A. Gadducci;A. Gargini;E. Palla;A. Fanucchi;A. Genazzani
背景
文献数据显示，中性粒细胞减少性小肠结肠炎是一种罕见但严重的并发症，可能发生在接受化疗（尤其是紫杉烷类）治疗的癌症患者中。
病例报告
一名患有 IIIc 期上皮性卵巢癌的 60 岁女性在第一个术后周期紫杉醇（175 mg/m2 3 小时输注）加卡铂化疗后一周出现中性粒细胞减少性发热、腹痛、严重腹泻、恶心、呕吐和口腔粘膜炎。腹部 X 线检查显示回肠和结肠环弥漫性扩张，伴有空气/液体。经过重症支持治疗后，患者很快康复。第二个周期紫杉醇剂量减少20%，但9天后，患者再次出现严重中性粒细胞减少症，伴有发烧、腹部绞痛、腹泻和呕吐。入院时采集的血样培养结果显示大肠杆菌呈阳性，而粪便的肠杆菌和艰难梭菌毒素呈阴性。患者在重症支持护理下康复，并继续使用单药卡铂进行化疗。
讨论
紫杉醇在上皮性卵巢癌一线和挽救治疗中的使用增加可能会增加这种恶性肿瘤患者中性粒细胞减少性小肠结肠炎的发生率。对于接受紫杉类化疗的患者，应强调中性粒细胞减少性发热、腹痛和压痛以及严重腹泻等症状的重要性，并应立即开始重症支持治疗管理。
BACKGROUND
Literature data show that neutropenic enterocolitis is a rare but severe complication that can occur in cancer patients treated with chemotherapy and especially with taxanes.
CASE REPORT
A 60-year-old woman with stage Illc epithelial ovarian cancer developed neutropenic fever, abdominal pain, severe diarrhoea, nausea, vomiting and oral mucositis one week after the first postoperative cycle of paclitaxel (175 mg/m2 3-hour infusion) plus carboplatin-based chemotherapy. Abdominal X-ray showed diffuse dilatation of the ileal and colonic loops with air/fluid. The patient soon recovered after intensive supportive care. For the second cycle the dose of paclitaxel was reduced by 20%, but nine days later the patient again developed severe neutropenia with fever, abdominal colicky pain, diarrhoea and vomiting. The culture of blood samples collected on admission was found to be positive for Escherichia coli, whereas stools resulted negative for both enteric rods and Clostridium difficile toxin. The patient recovered with intensive supportive care, and chemotherapy was continued with single-agent carboplatin.
DISCUSSION
The increasing use of paclitaxel in first-line as well as in the salvage treatment of epithelial ovarian cancer could increase the occurrence of neutropenic enterocolitis in patients with this malignancy. The importance of symptoms such as neutropenic fever, abdominal pain and tenderness and severe diarrhoea should be stressed in patients who receive taxane-based chemotherapy, and intensive supportive care management should be started immediately.
卡铂和紫杉醇作为复发性上皮性卵巢癌初始二线治疗的回顾性分析：在卵巢癌动态疾病状态模型中的应用。
DOI：
10.1200/jco.2002.20.5.1238
发表时间：
2002
期刊：
Journal of clinical oncology : official journal of the American Society of Clinical Oncology
影响因子：
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作者：
Dizon,DonS;Hensley,MarteeL;Poynor,ElizabethA;Sabbatini,Paul;Aghajanian,Carol;Hummer,Amanda;Venkatraman,Ennapadam;Spriggs,DavidR
通讯作者：
Spriggs,DavidR