Ifosfamide-induced encephalopathy in patients with uterine sarcoma.
OBJECTIVE
To report two cases of recurrent uterine sarcoma that developed ifosfamide-induced encephalopathy (IIE) with successful management.


METHODS
The patient in the first case developed grade 4 toxicity and had a partial response after the fourth dose of intravenous methylene blue was administered. Full recovery occurred 4 days after the development of IIE. The patient in the second case, who had grade 3 toxicity, had completely recovered 32 hours after the first dose of thiamine.


CONCLUSIONS
Careful evaluation of patients with recurrent gynecologic cancers and vigilance during infusion of chemotherapeutic regimens are important in reducing the risk and timely management of IIE. Both methylene blue and thiamine appear to be effective treatments for IIE.
Liu
Yung-Liang
YL
Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Tsai
Shih-Hung
SH
Chang
Fung-Wei
FW
Yu
Mu-Hsien
MH
D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage / Q000009:adverse effects*; D008751:Methylene Blue / Q000627:therapeutic use; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D020258:Neurotoxicity Syndromes / Q000188:drug therapy / Q000209:etiology*; D012509:Sarcoma / Q000188:drug therapy*; D013831:Thiamine / Q000627:therapeutic use; D014594:Uterine Neoplasms / Q000188:drug therapy*; D014803:Vitamin B Complex / Q000627:therapeutic use
D018906:Antineoplastic Agents, Alkylating; D014803:Vitamin B Complex; D008751:Methylene Blue; D007069:Ifosfamide; D013831:Thiamine