安罗替尼致间质性肺水肿

Interstitial pulmonary edema induced by anlotinib

1例57岁男性患者因肺腺癌根治术辅助化疗后出现脑转移接受安罗替尼12 mg口服、1次/d(用药2周、停用1周)+替莫唑胺150 mg口服、1次/d(用药3周、停用1周)联合抗肿瘤治疗。治疗5个月后,患者出现咳嗽、胸闷、劳力性呼吸困难等症状,且进行性加重。实验室检查、心电图、心脏超声检查等未见明显异常,胸部CT检查示两肺出现间质性肺水肿,考虑与安罗替尼有关。停用安罗替尼与替莫唑胺,给予糖皮质激素和对症治疗。5 d后,患者胸闷、咳嗽等症状缓解,换用贝伐珠单抗联合替莫唑胺抗肿瘤治疗,未出现不适。1个月后复查胸部CT,两肺间质性水肿较前吸收。

A 57‑year‑old male patient with brain metastases after radical resection of adenocarcinoma of the lung and adjuvant chemotherapy received anlotinib 12 mg orally once daily(2 weeks on and 1 week off)combined with temozolomide 150 mg orally once daily(3 weeks on and 1 week off).After 5 months of treatments,the patient developed symptoms such as cough,chest tightness,and exertional dyspnea,which gradually worsened.No obvious abnormalities were found in laboratory tests,electrocardiogram,or cardiac echocardiography.Chest CT examination showed interstitial pulmonary edema in bilateral lungs,which was considered to be related to anlotinib.Anlotinib and temozolomide treatments were stopped and glucocorticoid and symptomatic treatments were given.Five days later,the patient′s cough,chest tightness,and other symptoms were relieved.Anlotinib was replaced by bevacizumab,which was combined with temozolomide to continue the anti‑tumor treatment,and the patient did not experience discomfort.One month later,chest CT showed that the interstitial edema in bilateral lungs was markedly absorbed.