Abstract
FOLFOX regimen comprised oxaliplatin, 5-FU and leucovorin has been widely used as an effective approach for treating advanced colorectal cancer. Toxicities induced by oxaliplatin have been well known and are mostly moderate and manageable. Gastrointestinal, hematological and neurosensory toxicities are the most common. However, we have only limited information concerning the pulmonary toxicity of this regimen and only few cases of severe lung toxicity associated with FOLFOX regimen have been reported. We report here a case of interstitial pneumonia which was associated with FOLFOX regimen in a patient with metastatic advanced rectal cancer. The patient was a 73-year-old man. Following high anterior resection of rectum for rectal cancer with multiple liver metastases, FOLFOX regimen was started. During the treatment, he developed dyspnea, sweating, and hypotension. Withdrawal of the regimen and administration of steroids resulted in symptomatic remission, and the patient was discharged from the hospital. On and after 4th day after discharge, he had chill and was seen at the hospital on the 7th day after discharge. Chest CT scan showed ground glass attenuation in the bilateral lung fields and an increase in serum KL-6 level was noted. Drug-induced interstitial pneumonia was diagnosed. Symptomatic remission was confirmed after hyperbaric oxygenation.
Although interstitial pneumonitis caused by FOLFOX regimen is infrequent, it can be a severe complication. Periodic X-ray examinations and early detection of symptoms are important.
