口腔癌の同時化学放射線療法後にS-1誘発性の重篤な薬剤性肺障害を発症した1例

Abstract

A 70-year-old woman with multiple oral cancers received concurrent chemoradiation therapy with S-1 (50 mg/day). The patient received S-1 for 33 days and a total radiation dose of 66 Gy. The patient complained of a mild fever after therapy. She was treated in the department of pulmonary medicine in this hospital for subsequent dyspnea and hypoxemia. Computed tomography (CT) showed extensive groundglass opacity and diffuse consolidation changes in both lungs. She required endotracheal intubation, ventilator support, oxygen therapy, and steroid pulse therapy. These treatments remarkably improved her symptoms, and the abnormal findings on CT also resolved. A drug-induced lymphocyte stimulating test for S-1 demonstrated a positive reaction. These findings indicated a diagnosis of lung injury with acute respiratory distress syndrome induced by S-1. Drug-induced lung injury should to be considered in the differential diagnosis when patients treated with S-1 therapy present with fever and dyspnea.