title: An oral fluoropyrimidine agent S-1 induced interstitial lung disease: A case report.
abstract: A 66-year-old Japanese man with pancreatic cancer received eleven courses of gemcitabine monotherapy. The tumor responded to gemcitabine until metastatic liver tumors progressed. Subsequently, he was treated with S-1, an oral fluoropyrimidine anticancer agent, as salvage chemotherapy. Forty-two days after initiating S-1, he presented with dyspnea and fever. Chest computed tomography showed diffuse interstitial lesions with thickening of the alveolar septa and ground glass opacity. Serum KL-6 level was elevated to 1,230 U/mL and he did not use any other drugs except insulin. Thus, the development of interstitial lung disease (ILD) was considered to be due to S-1. Arterial blood oxygen pressure was 49.6 Torr in spite of oxygen administration (5 L/min). Steroid therapy improved his symptoms and the interstitial shadows on chest radiograph. Although S-1-induced ILD has mostly been reported to be mild, clinicians should be aware that S-1 has the potential to cause fatal ILD.
authors.affiliation: Hiromichi Yamane, Masahide Kinugawa, Shigeki Umemura, Yasuhiro Shiote, Kenichiro Kudo, Toshimitsu Suwaki, Haruhito Kamei, Division of Clinical Oncology, Sumitomo-Besshi Hospital Cancer Center, 3-1 Ohji-cho, Niihama, Ehime 792-8543, Japan.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Yamane
authors.forename: Masahide
authors.initials: M
authors.lastname: Kinugawa
authors.forename: Shigeki
authors.initials: S
authors.lastname: Umemura
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shiote
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Kudo
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Suwaki
authors.forename: Haruhito
authors.initials: H
authors.lastname: Kamei
authors.forename: Nagio
authors.initials: N
authors.lastname: Takigawa
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Kiura