Annals of Coloproctology

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Case Report

Oxaliplatin-induced Pulmonary Fibrosis: Two Case Reports: Chun-Geun Ryu, Eun-Joo Jung, Gangmi Kim, Su Ran Kim, Dae-Yong Hwang; J Korean Soc Coloproctol. 2011;27(5):266-269. Published online October 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.5.266

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Oxaliplatin with infusional 5-fluorouracil plus leucovorin (FOLFOX regimen) is the one of the standard chemotherapy regimens for treating a colorectal carcinoma. The most common side effects include neutropenia, diarrhea, vomiting and peripheral neuropathy, and these are moderate and manageable. However, pulmonary toxicity is rarely reported to be associated with the FOLFOX regimen. Moreover, there is no established guideline for the management of this side effect. Here, along with a literature review, we report two cases of rapidly developing pulmonary fibrosis related to the use of the FOLFOX regimen in patients with colorectal carcinomas.

Citations

Citations to this article as recorded by

The intervention of B. longum metabolites in Fnevs' carcinogenic capacity: A potential double-edged sword
Jingyu Xu, Xinyu Wu, Luyi Yang, Xiaoxi Xu
Experimental Cell Research.2025; 445(1): 114407. CrossRef
Oxaliplatin-Induced Pulmonary Fibrosis: A Rare but Fatal Reality
Kinnera Sahithi Urlapu, Dmitry Lvovsky
Cureus.2023;[Epub] CrossRef
Pulmonary Fibrosis Secondary to Oxaliplatin Treatment: From Rarity to Reality: A Case Study and Literature Review
Ana C. Moreira, João Portela, Carlos Couto, José Duarte, Natália Martins, Jorge Soares
Oncology and Therapy.2020; 8(2): 183. CrossRef
A case report of acute pulmonary hypertension after hyperthermic intraperitoneal chemotherapy (HIPEC) and review of the literature
Thomas S. Zajonz, Michael Sander, Winfried Padberg, Andreas Hecker, Ruediger Hörbelt, Christian Koch, Emmanuel Schneck
Annals of Medicine and Surgery.2018; 27: 26. CrossRef
Prognosis and treatment of FOLFOX therapy related interstitial pneumonia: a plea for multimodal immune modulating therapy in the respiratory insufficient patient
Annick De Weerdt, Amélie Dendooven, Annemie Snoeckx, Jan Pen, Martin Lammens, Philippe G. Jorens
BMC Cancer.2017;[Epub] CrossRef
Oxaliplatin-Induced Pulmonary Toxicity in Gastrointestinal Malignancies: Two Case Reports and Review of the Literature
Mor Moskovitz, Mira Wollner, Nissim Haim
Case Reports in Oncological Medicine.2015; 2015: 1. CrossRef
Pulmonary Fibrosis Secondary to FOLFOX Chemotherapy: A Case Report
Wai Cheong Soon, Kate West, David Gibeon, Elizabeth Frances Bowen
Case Reports in Oncology.2014; 7(3): 662. CrossRef
Granulomatous Lung Disease Requiring Mechanical Ventilation Induced by a Single Application of Oxaliplatin-Based Chemotherapy for Colorectal Cancer: A Case Report
Dane Wildner, Frank Boxberger, Axel Wein, Kerstin Wolff, Heinz Albrecht, Gudrun Männlein, Rolf Janka, Kerstin Amann, Jürgen Siebler, Werner Hohenberger, Markus F. Neurath, Richard Strauß
Case Reports in Oncological Medicine.2013; 2013: 1. CrossRef

Clinical Trial

Hematologic and Non-hematologic Toxicity after Intravenous Adjuvant 5-Fluorouracil and Leucovorin Treatment of Colorectal Cancer: A Prospective Study.: Lee, Kyu Jae , Moon, Sun Mi , Hwang, Dae Yong; J Korean Soc Coloproctol. 2005;21(6):426-432.

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Abstract PDF: PURPOSE
Although large clinical trials have been performed attempting to find an optimal 5-fluorouracil (5-FU)-based regimen on the basis of activity and toxicity, there have been few data reporting the toxicity. We experienced a less severe toxicity than previous reports, so we undertook an analysis of the toxicity profiles of 5-FU-based chemotherapy on colorectal cancer patients.
METHODS
Forty-two patients were consecutively enrolled in this study from Sep. 2002 to Sep. 2003. The primary endpoints were the incidences of anorexia, nausea, vomiting, diarrhea, constipation, headache, stomatitis, alopecia, and leukopenia, as recorded with the standard National Cancer Institute- Common Toxicity Criteria (NCI-CTC). The regimen used in this study was intravenous infusion of 5-FU, 500 mg/m2, plus leucovorin (LV), 20 mg, daily for 5 days every 4 weeks for 6 cycles. Information on toxic profiles was obtained by questionnaire and blood test data during each cycle of treatment.
RESULTS
Of the patients, 73.8% experienced at least one type of toxicity. There were no clinical grade 3/4 toxicities. Toxicites (grade 1/2) were as follows: anorexia (51.2%), nausea (50.4%), constipation (24.6%), headache (11.5%), vomiting (4.0%), diarrhea (2.4%), alopecia (2.0%), stomatitis (0.4%), and leukopenia (4.0%). The most common adverse event was gastrointestinal toxicity (16.6%). There were no deaths attributed to non-hematologic toxicity. There was no dose reduction during any cycle of treatment. In a comparison of the incidence of toxicity by age (<65 and > or =65), gender, and TNM stage, univariate analysis found no statistical differences.
CONCLUSIONS
Our data would seem to confirm that Korean patients experienced less incidence and severity of toxicity than Western patients. We believe that the accumulated data provide sufficient evidence that colorectal patients in Korea actually experience a less severe toxicity of 5-FU-based chemotherapy when they are treated on this schedule. Considering this study, a race-specific dose determination for a colorectal cancer adjuvant chemotherapeutic setting is warranted.

Original Article

Toxicity Evaluation of Oral Adjuvant Chemotherapeutic Drugs UFT Versus UFT-E in the Colorectal Cancer.: Hong, Hyoun Kee , Cho, Yeong Kyu , Kim, Hee Cheol , Yu, Chang Sik , Kim, Tae Won , Lee, Je Hwan , Kim, Jin Cheon; J Korean Soc Coloproctol. 2001;17(1):33-37.

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Abstract PDF: PURPOSE
Oral UFT is known to be a safe and effective antineoplastic regimen for adjuvant chemotherapy of colorectal cancer. As it sometimes produces upper gastrointestinal symptoms such as anorexia, nausea, vomiting and abdominal pain, medication should be stopped transiently or dosage reduced. UFT-E, an enteric coated granule of UFT was introduced to reduce UGI toxicity. We analyzed the toxicity of UFT and UFT-E prospectively for the purpose of comparison between the two types.
METHODS
The toxicity of UFT and UFT-E were evaluated in 83 patients (UFT; 45, UFT-E; 38) with colorectal cancer who underwent curative surgery according to the WHO toxicity criteria. All patients were selected consecutively with patients' approval and by the "Institutional Review Board, Asan Medical Center".
RESULTS
The toxicity incidence in UFT-E group was slightly less than that in UFT group without statistical significance. The severity of toxicity seemed to be mild within grade 1 or 2 and most of them toxicity self-limiting. The regimen was completely interrupted in 9 patients (20%) in the UFT group, 3 patients (7.9%) in the UFT-E group due to severe UGI symptoms, prolonged leukopenia, derrangement of liver function and skin rash.
CONCLUSIONS
Toxicity rate of UFT-E was not higher than that of UFT. But we cannot prove superiority of UFT-E on UGI toxicity. Oral UFT-E can be administered safely on an outpatient basis without lethal toxicity requiring hospitalization.

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