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Title: A case of progressive digital ischemia after early withdrawal of gemcitabine and S-1 in a patient with systemic sclerosis.
Authors: Zaima, C
Kanai, M  kyouindb  KAKEN_id
Ishikawa, S
Kawaguchi, Y  kyouindb  KAKEN_id
Masui, T  kyouindb  KAKEN_id  orcid (unconfirmed)
Mori, Y  kyouindb  KAKEN_id
Nishimura, T  kyouindb  KAKEN_id
Matsumoto, S  kyouindb  KAKEN_id
Yanagihara, K
Chiba, T  kyouindb  KAKEN_id
Mimori, T  kyouindb  KAKEN_id
Author's alias: 金井, 雅史
Keywords: gemcitabine
systemic scleroderma
Issue Date: Jun-2011
Publisher: Oxford University Press
Journal title: Japanese journal of clinical oncology
Volume: 41
Issue: 6
Start page: 803
End page: 806
Abstract: 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 Any resulting digital ischemia might be refractory to treatment and worsen progressively, even if chemotherapy is withdrawn in the early stages of digital ischemia.
Rights: © The Author (2011). Published by Oxford University Press.
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。This is not the published version. Please cite only the published version.
DOI(Published Version): 10.1093/jjco/hyr045
PubMed ID: 21478179
Appears in Collections:Journal Articles

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