title: [A case with delayed-onset radiation pneumonitis suspected to be induced by oral etoposide].
abstract: Radiation pneumonitis usually occurs within 1-3 months after the completion of radiation therapy. A 63-year-old male with primary lung cancer treated by radiation therapy developed radiation pneumonitis 5 months after the completion of radiation therapy. He received 60 Gy to the lung tumor in a conventional fractionation schedule, and then two courses of intravenous chemotherapy using cis-diamine-dichloroplatinum (II) (110-140 mg) and etoposide (140-175 mg). Oral etoposide was initiated for bone metastases on the 104th day after the completion of radiation therapy at a daily dose of 20 mg, to a total dose of 1075 mg. He complained of fever and exertional dyspnea 5 months after the completion of radiation therapy. Chest radiography showed homogeneous infiltrates in the irradiated lung. These clinical signs and symptoms were refractory to antibiotic therapy, but steroid therapy resulted in marked improvement. The development of radiation pneumonitis was suspected to be induced by oral etoposide, which was given before the onset of radiation pneumonitis. These data suggest that etoposide induces a recall phenomenon, as has been demonstrated with such drugs as adriamycin and actinomycin-D.
authors.affiliation: Department of Radiology, Ehime University School of Medicine.
authors.forename: M
authors.initials: M
authors.lastname: Kataoka
authors.forename: M
authors.initials: M
authors.lastname: Kawamura
authors.forename: Y
authors.initials: Y
authors.lastname: Nishiyama
authors.forename: H
authors.initials: H
authors.lastname: Higashino
authors.forename: T
authors.initials: T
authors.lastname: Fujii
authors.forename: H
authors.initials: H
authors.lastname: Mogami
authors.forename: H
authors.initials: H
authors.lastname: Itoh
authors.forename: A
authors.initials: A
authors.lastname: Iio
authors.forename: K
authors.initials: K
authors.lastname: Hamamoto
mesh_terms: D000284:Administration, Oral; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018288:Carcinoma, Small Cell / Q000188:drug therapy / Q000532:radiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005047:Etoposide / Q000009:adverse effects*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000209:etiology*; D011832:Radiation Injuries / Q000209:etiology*; D011882:Radiotherapy, High-Energy / Q000009:adverse effects*
chemical_list: D005047:Etoposide; D002945:Cisplatin