吉非替尼致视网膜出血

Retinal hemorrhage caused by gefitinib

1例49岁男性患者因肺腺癌Ⅳ期接受化疗,具体方案为培美曲塞二钠0.8 g入0.9%氯化钠注射液100 ml静脉滴注、第1天,顺铂30 mg入0.9%氯化钠注射液250 ml静脉滴注、第1~4天,21 d为1个周期;同时给予靶向治疗,吉非替尼口服250 mg、1次/d。在第3个化疗周期停药第10天、服用吉非替尼第59天,患者出现头晕、视力下降。眼科检查结果为视网膜出血、眼压升高,考虑可能与吉非替尼有关。因患者病情需要,继续原方案治疗,同时给予降眼压和恢复视力治疗。继续原方案治疗第4天,患者头晕症状稍有好转,但视力未见改善;第10天视力仍未恢复。此后患者失访。

A 49‑year‑old male patient with stage IV lung adenocarcinoma received IV infusions of pemetrexed disodium 0.8 g dissolved in 0.9%sodium chloride injection 100 ml on the 1st day and cisplatin 30 mg dissolved in 0.9%sodium chloride injection 250 ml in the first 4 days(each treatment cycle was 21 days).At the same time,he received targeted therapy with gefitinib 250 mg orally once daily.On the 10th day of drug withdrawal in the third chemotherapy cycle,the 59th day of gefitinib administration,the patient developed dizziness and decreased vision.The ophthalmic examination showed retinal hemorrhage and levated intraocular pressure,which were considered to be related to gefitinib.Because of the patient′s condition,the original treatments were continued,and the treatments of reducing intraocular pressure and restoring vision were given at the same time.On the 4th day of the continuation of original treatments,his dizziness was slightly improved,but the visual was not.On the 10th day,his vision did not recover.After that,the patient was lost to follow‑up.