title: Interstitial lung disease in a patient treated with oxaliplatin, 5-fluorouracil and leucovorin (FOLFOX) for metastatic colorectal cancer.
abstract: BACKGROUND
  Oxaliplatin in combination with 5-fluorouracil (5-FU) and leucovorin (FOLFOX) is a common chemotherapeutic regimen for advanced colorectal cancer. Here, we present a case of interstitial lung disease associated with FOLFOX therapy.
  
  
  METHODS
  A 74-year-old man with a history of metastatic colorectal cancer was admitted with a four week history of progressive dyspnoea and evidence of severe respiratory failure. He had recently completed six cycles of FOLFOX chemotherapy in the months prior to presentation. Investigations did not reveal convincing evidence of infection or pulmonary embolism. CT chest demonstrated widespread pulmonary infiltrates and interlobular septal thickening. The patient was commenced on both broad spectrum antibiotic therapy and high dose corticosteroid treatment however his respiratory failure continued to progress. The patient died four days after admission due to progressive respiratory failure. Subsequent post-mortem examination demonstrated evidence of diffuse alveolar damage without evidence of tumour infiltration, infection or pulmonary embolism.
  
  
  CONCLUSIONS
  Although infrequent, pulmonary toxicity can occur in association with FOLFOX therapy. Cessation of therapy and prompt initiation of corticosteroids may improve outcomes.
authors: Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia ;  Institute for Breathing and Sleep, Austin Hospital, Heidelberg, Victoria, Australia.
authors: Liam M
authors: LM
authors: Hannan
authors: Jaclyn
authors: J
authors: Yoong
authors: Geoffrey
authors: G
authors: Chong
authors: Christine F
authors: CF
authors: McDonald
keywords: diffuse alveolar damage; interstitial lung disease; oxaliplatin