A Case of Recurrent Gastric Cancer followed by Fatal Interstitial Pneumonitis after Paclitaxel Administration

Tadaaki Noguchi, Masaki Ueno, Harushi Udagawa, Kazuhisa Ehara, Shinji Mine, Yoshihiro Kinoshita, Kenji Tsutsumi, Masaji Hashimoto, Toshihito Sawada and Goro Watanabe

Department of Gastrointestinal Surgery, Toranomon Hospital

A 77-year-old man with no history of thoracic radiotherapy or interstitial pneumonitis was administered paclitaxel (PXL) for peritoneal dissemination of gastric cancer in August 2004. After PXL, he had dyspnea, and high resolution CT (HRCT) showed reticular infiltrations in both lung fields, yielding a diagnosis of paclitaxel-induced pneumonitis. Steroid pulse therapy and mechanical ventilatory support improved his condition temporarily, but general state got worse and he died. There have been 14 reports of PXL-induced pneumonitis for cancer patients. Only 5 cases, including ours, were fatal. There is no significant prognostic factor, but KL-6 seemed to be a good prognostic factor in our case. It is therefore important to check the patient's condition when PXL is administered. Pneumonitis should be noted and, when it is suspected, chemotherapy must be stopped and treatment should be started immediately.

Key words
drug-induced pneumonitis, paclitaxel, gastric cancer

Reprint requests
Tadaaki Noguchi Department of Gastrointestinal Surgery, Toranomon Hospital
2-2-2 Toranomon, Minato-ku, 105-8470 JAPAN

Accepted
February 22, 2006

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