A 66-year-old Japanese man with pancreatic cancer received eleven courses of gemcitabine monotherapy.The tumor responded to gemcitabine until metastatic liver tumors progressed.Subsequently,he was treated with S-1,an ...A 66-year-old Japanese man with pancreatic cancer received eleven courses of gemcitabine monotherapy.The tumor responded to gemcitabine until metastatic liver tumors progressed.Subsequently,he was treated with S-1,an oral fluoropyrimidine anticancer agent,as salvage chemotherapy.Forty-two days after initiating S-1,he presented with dyspnea and fever.Chest computed tomography showed diffuse interstitial lesions with thickening of the alveolar septa and ground glass opacity.Serum KL-6 level was elevated to 1,230 U/mL and he did not use any other drugs except insulin.Thus,the development of interstitial lung disease(ILD)was considered to be due to S-1.Arterial blood oxygen pressure was 49.6 Torr in spite of oxygen administration(5 L/min).Steroid therapy improved his symptoms and the interstitial shadows on chest radiograph.Although S-1-induced ILD has mostly been reported to be mild,clinicians should be aware that S-1 has the potential to cause fatal ILD.展开更多
文摘A 66-year-old Japanese man with pancreatic cancer received eleven courses of gemcitabine monotherapy.The tumor responded to gemcitabine until metastatic liver tumors progressed.Subsequently,he was treated with S-1,an oral fluoropyrimidine anticancer agent,as salvage chemotherapy.Forty-two days after initiating S-1,he presented with dyspnea and fever.Chest computed tomography showed diffuse interstitial lesions with thickening of the alveolar septa and ground glass opacity.Serum KL-6 level was elevated to 1,230 U/mL and he did not use any other drugs except insulin.Thus,the development of interstitial lung disease(ILD)was considered to be due to S-1.Arterial blood oxygen pressure was 49.6 Torr in spite of oxygen administration(5 L/min).Steroid therapy improved his symptoms and the interstitial shadows on chest radiograph.Although S-1-induced ILD has mostly been reported to be mild,clinicians should be aware that S-1 has the potential to cause fatal ILD.