論文の公開元へセツキシマブ併用放射線治療中にニューモシスチス肺炎を発症し，診断に苦慮した１例
概要
A 66-year-old man underwent bioradiotherapy (BRT) with cetuximab for oropharyngeal cancer. Six days after BRT he developed a fever and elevated inflammatory markers. His chest CT showed only mild radiation pneumonitis in the apex of his lung. After the initial treatment using antibiotics he showed diffuse ground glass opacity on his chest CT. He was finally diagnosed with pneumocystis pneumonia (PCP) by bronchoalveolar lavage. After oral administration of sulfamethoxazole-trimethoprim his clinical symptoms were immediately cured. Cetuximab is a recombinant human/mouse chimeric epidermal growth factor receptor (EGFR) monoclonal antibody, which was approved for head and neck cancer in Japan in 2012. Pneumocystis pneumonia during BRT with cetuximab for head and neck cancer is extremely rare. We investigated 7 patients, including the present patient, treated by BRT with cetuximab in our hospital and found that all of the patients’ lymphocytes during BRT were under 500/μl, which could be a risk factor for PCP. It should be recognized that the depletion of lymphocytes in BRT can result in PCP. Shinshu Med J 69 : 245―251, 2021
