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タイトル: | A case of progressive digital ischemia after early withdrawal of gemcitabine and S-1 in a patient with systemic sclerosis. |
著者: | Zaima, C Kanai, M Ishikawa, S Kawaguchi, Y Masui, T https://orcid.org/0000-0002-4001-4824 (unconfirmed) Mori, Y Nishimura, T Matsumoto, S https://orcid.org/0000-0001-6453-7489 (unconfirmed) Yanagihara, K Chiba, T Mimori, T |
著者名の別形: | 金井, 雅史 |
キーワード: | gemcitabine necrosis S-1 systemic scleroderma toxicity |
発行日: | Jun-2011 |
出版者: | Oxford University Press |
誌名: | Japanese journal of clinical oncology |
巻: | 41 |
号: | 6 |
開始ページ: | 803 |
終了ページ: | 806 |
抄録: | The safety of chemotherapy for patients with systemic sclerosis is unclear, and there are few published reports documenting the side effects of chemotherapy in patients with this condition. Here, we report the case of a patient with systemic sclerosis who developed severe digital ischemia during combination gemcitabine/S-1 chemotherapy for pancreatic cancer. In spite of aggressive treatment, the digital ischemia progressively worsened and gangrenous changes developed in multiple fingers and toes. In this patient, the systemic sclerosis had been well controlled, with no digital ischemic symptoms for the previous 6 years, so this progressive clinical course in spite of aggressive treatment strongly suggests that the chemotherapy triggered or aggravated the digital necrosis. To the best of our knowledge, this is only the third reported case of a patient with systemic sclerosis developing digital necrosis after gemcitabine-based chemotherapy. The incidence of digital necrosis during chemotherapy in patients with systemic sclerosis is unknown, and the mechanism by which it occurs is unclear, but the three reports published to date, including the present case, suggest that physicians should be very cautious about administering gemcitabine-based chemotherapy to patients with systemic sclerosis. Any resulting digital ischemia might be refractory to treatment and worsen progressively, even if chemotherapy is withdrawn in the early stages of digital ischemia. |
著作権等: | © The Author (2011). Published by Oxford University Press. This is not the published version. Please cite only the published version. この論文は出版社版でありません。引用の際には出版社版をご確認ご利用ください。 |
URI: | http://hdl.handle.net/2433/156782 |
DOI(出版社版): | 10.1093/jjco/hyr045 |
PubMed ID: | 21478179 |
出現コレクション: | 学術雑誌掲載論文等 |
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