[Acute respiratory distress syndrome after antineoplastic chemotherapy. Probable role of gemcitabine].
BACKGROUND
A 4-week interval between radiotherapy and gemcitabin chemotherapy is recommended due to the risk of severe radiosensitization. Gemcitabin can also have severe lung toxicity late after or without prior radiotherapy.


METHODS
A patient was treated with thoracic radiotherapy for non-small-cell lung cancer. Five weeks later gemcitabin was given. A few days after the second gemcitabin cycle the patient developed severe respiratory distress. The clinical course was rapidly fatal despite corticosteroid therapy.


CONCLUSIONS
About 20 cases of severe lung toxicity due to gemcitabin have been reported in the literature, occurring late after radiotherapy or without radiotherapy. Corticosteroid therapy, whether given for prevention or cure, is not always effective. Four of these cases had a fatal outcome. The development of brief mild episodes of dyspnea is considered to be common after delivery of gemcitabin. If unexplained dyspnea persists for more than a few hours, severe lung toxicity is highly likely and gemcitabin should be interrupted.
de Lavigerie
B
B
Service de Médecine interne et Pneumologie, Centre Hospitalier Général d'Annonay.
Joasson
J M
JM
D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects* / Q000031:analogs & derivatives; D004334:Drug Administration Schedule; D017809:Fatal Outcome; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D012128:Respiratory Distress Syndrome / Q000139:chemically induced* / Q000175:diagnosis; D000093542:Gemcitabine
D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine