Severe acute interstitial pneumonia and gefitinib
Severe acute interstitial pneumonia and gefitinib
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DOI：
10.1016/s0140-6736(03)12190-3
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发表时间：
2003-01-11
期刊：
影响因子：
168.9
通讯作者：
Nukiwa, T
中科院分区：
文献类型：
--
作者：
Inoue, A;Saijo, Y;Nukiwa, T
吉非替尼是一种表皮生长因子受体酪氨酸激酶的口服选择性抑制剂，是铂类化疗无效的晚期非小细胞肺癌患者的有效治疗药物。我们评估了四名非小细胞肺癌患者，他们与吉非替尼相关，导致严重的急性间质性肺炎。虽然两名患者在类固醇治疗后康复，但另外两名患者死于进行性呼吸功能障碍。根据尸体解剖和胸部CT中弥漫性磨玻璃样阴影的双侧分布，我们诊断为弥漫性肺泡损伤，这与急性间质性肺炎一致。间质性肺炎患者还存在其他肺部疾病，如既往胸部放疗和体能状态差。医生应该意识到吉非替尼引起的肺泡损伤，特别是对于具有这些特征性特征的患者。
Gefitinib is an oral selective inhibitor of the epidermal growth factor receptor tyrosine kinase that is an effective treatment for patients with advanced non-small cell lung cancer who do not respond to platinum-based chemotherapy. We assessed four patients who had non-small cell lung cancer causing severe acute interstitial pneumonia in association with gefitinib. Although two patients recovered after treatment with steroids, the other two died from progressive respiratory dysfunction. On the basis of autopsies and bilateral distribution of diffuse ground-glass opacities In chest CTs, we diagnosed diffuse alveolar damage, which was consistent with acute interstitial pneumonia. Patients with interstitial pneumonia also had other pulmonary disorders such as previous thoracic irradiation and poor performance status. Physicians should be aware of the alveolar damage induced by gefitinib, especially for patients with these characteristic features.