title: Pulmonary fibrosis after chemotherapy with oxaliplatin and 5-fluorouracil for colorectal cancer.
abstract: BACKGROUND
  Chemotherapy with oxaliplatin and 5-fluorouracil (5-FU)/folinic acid is the standard first-line therapy of metastatic colorectal carcinoma and has shown activity in several other malignancies. This regimen is mostly well tolerated. Known side effects include myelosuppression, nausea/vomiting and neuropathies; acute pulmonary toxicity has only been described in very few reports.
  
  
  METHODS
  A 66-year-old male with metastatic rectal adenocarcinoma treated with 12 cycles of oxaliplatin and 5-FU/folinic acid developed bilateral pulmonary infiltrates and respiratory failure. Broad-spectrum antibiotic therapy did not improve his condition and extended microbiological diagnostics did not show an infectious etiology. Therapy with corticosteroids led to a short improvement, however the patient died 1 week after the initiation of corticosteroid treatment due to respiratory insufficiency. The clinical and histopathological data as well as the lack of an infectious cause indicate that pulmonary fibrosis was induced by oxaliplatin and 5-FU/folinic acid.
  
  
  CONCLUSIONS
  This case demonstrates that treatment with oxaliplatin and 5-FU/folinic acid can cause acute pulmonary fibrosis. Even though pulmonary toxicity is rare in patients treated with this chemotherapy regimen compared to infectious pulmonary complications, it should be considered early in the clinical course of otherwise unexplained pulmonary infiltrates hopefully leading to a better outcome.
authors.affiliation: University Medicine Berlin, Campus Benjamin Franklin, Charité, Berlin, Germany. pamela.mundt@charite.de
authors.forename: Pamela
authors.initials: P
authors.lastname: Mundt
authors.forename: Hans-Christian
authors.initials: HC
authors.lastname: Mochmann
authors.forename: Harald
authors.initials: H
authors.lastname: Ebhardt
authors.forename: Martin
authors.initials: M
authors.lastname: Zeitz
authors.forename: Rainer
authors.initials: R
authors.lastname: Duchmann
authors.forename: Matthias
authors.initials: M
authors.lastname: Pauschinger
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008297:Male; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D011658:Pulmonary Fibrosis / Q000139:chemically induced* / Q000188:drug therapy; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D005472:Fluorouracil