A case of whole body pneumatosis after radiotherapy with cetuximab

Abstract

Several new serious adverse events of cetuximab have been reported in a clinical site for squamous cell carcinoma of the head and neck （SCCHN）, whereas the most common adverse events in clinical trials are infusion reaction, interstitial pneumonia, skin rash and nail toxicity. Here we describe a patient’s serious outcome because of his whole body pneumatosis after cetuximab containing bio-radiotherapy （BRT）. We performed cetuximab containing BRT for the patient, a 76-year-old man who had a cT3N0M0 squamous cell carcinoma at the right arytenoid. He had a past history of endoscopic submucosal dissection （ESD） for esophageal cancer, endoscopic laryngo-pharyngeal surgery （ELPS） for hypopharyngeal cancer, and gastric ulcer. In this case, BRT consisted of conformal radical radiotherapy （70 Gy in 35 fractions）, with only six cycles of cetuximab because of shingles at the right precordium and aspiration pneumonia. Nine days after the last cetuximab treatment, whole body pneumatosis was found on computed tomographic scans （CT）. Following nothing per os （NPOs） and intravenous antibiotics, this complication was resolved in about 10 days.