title: Canalicular and nasolacrimal duct blockage: an ocular side effect associated with the antineoplastic drug S-1.
abstract: OBJECTIVE
  To report canalicular stenosis as a side effect of the new antineoplastic agent S-1.
  
  
  METHODS
  Interventional case series.
  
  
  METHODS
  Three patients who received S-1 for treatment of gastrointestinal cancer at a tertiary cancer center were evaluated and treated for epiphora.
  
  
  RESULTS
  Two patients were found to have severe canalicular stenosis and nasolacrimal duct blockage after approximately 6 months of S-1 therapy. One patient underwent dacryocystorhinostomy with silicone tube placement on one side and dacryocystorhinostomy and Pyrex glass tube placement on the other side. The other patient declined a surgical intervention. One additional patient with epiphora had punctal stenosis early in the course of S-1 therapy. His epiphora resolved after probing and irrigation and 4 weeks of topical corticosteroid therapy.
  
  
  CONCLUSIONS
  Canalicular and nasolacrimal duct blockage is a previously unreported side effect of S-1 and should be recognized and treated at its earliest possible stage so that complete closure of the canaliculi can be avoided.
authors.affiliation: Section of Ophthalmology, Department of Plastic Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA. besmaeli@mdanderson.org
authors.forename: Bita
authors.initials: B
authors.lastname: Esmaeli
authors.forename: Dominick
authors.initials: D
authors.lastname: Golio
authors.forename: Linda
authors.initials: L
authors.lastname: Lubecki
authors.forename: Jaffer
authors.initials: J
authors.lastname: Ajani
mesh_terms: D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects*; D003608:Dacryocystorhinostomy; D004338:Drug Combinations; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy; D006801:Humans; D007440:Intubation; D007767:Lacrimal Duct Obstruction / Q000139:chemically induced* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000187:drug effects*; D010094:Oxonic Acid / Q000009:adverse effects*; D011725:Pyridines / Q000009:adverse effects*; D005641:Tegafur / Q000009:adverse effects*; D007507:Therapeutic Irrigation
chemical_list: D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; D011725:Pyridines; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid