[Pulmonary embolism in esophageal cancer patients receiving neoadjuvant chemotherapy with CDDP and 5-FU].
We report our experience with 2 male patients (71 and 74 years old, respectively) with advanced esophageal cancer who exhibited pulmonary embolism during treatment with neoadjuvant chemotherapy with cisplatin (CDDP) and 5-fluorouracil (5- FU). The patients had no symptoms associated with pulmonary embolism. The pulmonary emboli were incidentally detected on computed tomography performed to assess the effect of chemotherapy. It was found that the pulmonary emboli were associated with the central venous catheter-associated thrombi. The pulmonary emboli were effectively treated with heparin in both patients. A recent meta-analysis showed that the risk of chemotherapy-associated venous thromboembolism was increased by 1.67-fold when CDDP was included in the chemotherapy regimen. The increased risk was proposed to be associated with CDDP-mediated endothelial cell injury, platelet activation, increased levels of coagulation factors, or renal damage. The pulmonary embolism in our cases may be ascribed to the central venous catheterization and the treatment with CDDP. A possible occurrence of venous thromboembolism should be kept in mind when CDDP is used, particularly with central venous catheterization, for the treatment of esophageal cancer.
Dept. of Surgery, Division of Digestive Surgery, Kyoto Prefectural University of Medicine.
Maki
M
Kitagawa
Atsushi
A
Shiozaki
Hitoshi
H
Fujiwara
Hirotaka
H
Konishi
Shuhei
S
Komatsu
Daisuke
D
Ichikawa
Kazuma
K
Okamoto
Yasutoshi
Y
Murayama
Yoshiaki
Y
Kuriu
Hisashi
H
Ikoma
Masayoshi
M
Nakanishi
Chouhei
C
Sakakura
Eigo
E
Otsuji
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D062905:Central Venous Catheters / Q000009:adverse effects*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D008297:Male; D020360:Neoadjuvant Therapy; D011655:Pulmonary Embolism / Q000139:chemically induced* / Q000628:therapy; D054556:Venous Thromboembolism / Q000139:chemically induced* / Q000628:therapy
D002945:Cisplatin; D005472:Fluorouracil