Fatal hemorrhage in a patient with advanced soft tissue sarcoma following radiation and pazopanib treatment: A case report.
Fatal hemorrhage in a patient with advanced soft tissue sarcoma following radiation and pazopanib treatment: A case report.
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DOI：
10.3892/ol.2016.4246
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发表时间：
2016-04
期刊：
影响因子：
2.9
通讯作者：
Kanai T
中科院分区：
文献类型：
--
作者：
Kawasaki K;Hamamoto Y;Fukada J;Adachi M;Sasaki H;Takaishi H;Yoshida K;Kanai T
一位71岁的日本女性因颞下窝平滑肌肉瘤和右肺85 mm转移到庆应义塾大学医学院神经外科（日本东京）就诊。由于肺部病变与气道阻塞的风险相关，因此对患者进行放射治疗（50戈伊/20次），导致肿瘤显著缩小。随后，患者接受800 mg/天帕唑帕尼治疗10周，导致肿瘤尺寸进一步缩小。然而，患者死于突发性大出血。致死性出血的三种可能的解释是：i）对帕唑帕尼的不良反应; ii）放射的副作用;和iii）显著的肿瘤缩小。因此，可以提出，上述假设的协同效应可能是造成本病例中观察到的出血的原因。因此，临床医生应警惕该不良事件的可能性。在本研究中，报告了第一例因放射治疗和随后的帕唑帕尼治疗引起的肿瘤明显缩小后大出血而死亡的病例。
A 71-year-old Japanese woman presented to the Department of Neurosurgery of Keio University School of Medicine (Tokyo, Japan) with a leiomyosarcoma originating in the infratemporal fossa and an 85-mm metastasis to the right lung. Since the pulmonary lesion was associated with risk of airway obstruction, radiation therapy (50 Gy/20 fractions) was administered to the patient, which resulted in remarkable tumor shrinkage. Subsequently, the patient was administered 800 mg/day pazopanib for 10 weeks, which resulted in further reduction in tumor size. However, the patient succumbed to a massive hemorrhage of sudden onset. Three possible explanations for the fatal hemorrhage are: i) adverse reaction to pazopanib; ii) side effects of radiation; and iii) remarkable tumor shrinkage. As a result, it may be proposed that the synergic effects of the aforementioned hypotheses may have been responsible for the bleeding observed in the present case. Therefore, clinicians should be alert to the possibility of this adverse event. In the present study, the first case of mortality due to massive hemorrhage following remarkable tumor shrinkage induced by radiation therapy and subsequent pazopanib treatment is reported.