Genestreti, Giovenzio;
Di Battista, Monica;
Trisolini, Rocco;
Denicolò, Fabio;
Valli, Mirca;
Lazzari-Agli, Luigi Arcangelo;
Dal Piaz, Giorgia;
De Biase, Dario;
Bartolotti, Marco;
Cavallo, Giovanna;
Brandes, Alba A.
A Commentary on Interstitial Pneumonitis Induced by Docetaxel: Clinical Cases and Systematic Review of the Literature
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Media type:
E-Article
Title:
A Commentary on Interstitial Pneumonitis Induced by Docetaxel: Clinical Cases and Systematic Review of the Literature
Contributor:
Genestreti, Giovenzio;
Di Battista, Monica;
Trisolini, Rocco;
Denicolò, Fabio;
Valli, Mirca;
Lazzari-Agli, Luigi Arcangelo;
Dal Piaz, Giorgia;
De Biase, Dario;
Bartolotti, Marco;
Cavallo, Giovanna;
Brandes, Alba A.
Description:
<jats:sec><jats:title>Background</jats:title><jats:p> Pulmonary toxicity is a well-known complication observed with several anticancer drugs. Docetaxel, a taxane chemotherapy drug widely used in the treatment of many types of solid tumors including non-small cell lung cancer (NSCLC), rarely causes infiltrative pneumonitis. The exact mechanism by which docetaxel develops this side effect is not well understood; probably it is produced by type I and IV hypersensitivity responses. Here we describe 2 cases of infiltrative pneumonitis induced by docetaxel as second-line chemotherapy in advanced NSCLC. </jats:p></jats:sec><jats:sec><jats:title>Materials and Methods</jats:title><jats:p> Two patients with advanced NSCLC were treated with weekly docetaxel as second-line chemotherapy. After 3 courses of chemotherapy, restaging computed tomography (CT) of the chest revealed bilateral diffuse ground-glass opacities with a peribronchial distribution possibly indicative of hypersensitivity pneumonitis. No evidence of pulmonary embolus or pleural effusion was found. Fiberoptic bronchoscopy showed normal bronchi without lymphangitis; biopsies showed interstitial fibrosis without tumor cells. Bronchial tissue laboratory tests for fungi or bacilli were negative. No malignant cells were found at bronchoalveolar lavage. The patients were given high-dose corticosteroid therapy with prednisone 0.7 mg per kilogram per day. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> After 1 month of therapy, contrast-enhanced chest CT showed complete disappearance of the pulmonary changes in both patients. Spirometry and blood gas analysis revealed complete recovery of pulmonary function. The patients continued their oncological follow-up program. </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> Pulmonary injury is a rare adverse event during docetaxel chemotherapy. Prompt treatment with high-dose corticosteroids is needed to avoid worsening of respiratory performance. </jats:p></jats:sec>