Radiation recall pneumonitis induced by gemcitabine.

Abstract

BACKGROUND:

Radiation recall pneumonitis describes a very rare reaction in a previously irradiated area of pulmonary tissue after application of pharmacological agents. A case of recall pneumonitis induced by gemcitabine is reported.

CASE REPORT:

A 64-year-old female patient with metastasized esophageal carcinoma received simultaneous chemoradiotherapy of the upper mediastinum with 50.4 Gy and cisplatin/5-fluorouracil. 8 months later she was scheduled for salvage chemotherapy with gemcitabine (1,000 mg/m(2) days 1 and 8) and docetaxel (75 mg/m(2) day 8) due to locally progressive disease. After having received gemcitabine on day 1 of the second course, the patient developed dry cough, subfebrile temperatures and dyspnea within 48 h. A CT of the thorax revealed newly developed bilateral pulmonary ground-glass opacity corresponding to the previous radiation fields. Chemotherapy was stopped and systemic application of prednisolone was initiated. 2 months later symptoms had resolved with a control CT of the thorax showing complete regression of the pulmonary changes.

CONCLUSION:

Gemcitabine-induced recall pneumonitis is a rarely reported phenomenon and should be taken into account even after extended time interval to the previous radiotherapy.

• Authors: Sebastian Schwarte, Katharina Wagner, Johann H Karstens, Michael Bremer
• Journal: Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] (Strahlenther Onkol) Vol. 183 Issue 4 Pg. 215-7 (Apr 2007) ISSN: 0179-7158 [Print] Germany
• PMID: 17406804 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antimetabolites, Antineoplastic
• Deoxycytidine
• Gemcitabine

Topics

• Antimetabolites, Antineoplastic (adverse effects)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Combined Modality Therapy
• Deoxycytidine (adverse effects, analogs & derivatives)
• Esophageal Neoplasms (drug therapy, pathology, radiotherapy)
• Female
• Humans
• Lymphatic Metastasis
• Middle Aged
• Neoplasm Metastasis
• Pneumonia (chemically induced, diagnostic imaging)
• Radionuclide Imaging
• Treatment Outcome
• Gemcitabine