Docetaxel-Induced Bilateral Cystoid Macular Edema with a Low Cumulative Dose: A Case Report

Said Iferkhass, Mohcine El Mhadi
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Abstract

Docetaxel and paclitaxel are taxanes. They are widely used chemotherapeutic agents that have been shown to be effective for various types of solid malignancies. Docetaxel-related bilateral toxic cystoid macular edema (T-CME) has been reported as a rare and unusual adverse reaction. We report a case of 43-year women treated for breast cancer with docetaxel and developed T-CME. She was treated with two cycles of Docetaxel 150 mg, Pertuzumab 420 mg and Trastuzumab 360mg. Three days after 2nd cycle she complained of diminution of vision. Her both eye visual acuity was 20/200. Fundus examination showed macular edema which was confirmed with SD-OCT and fluorescein angiography. After fourth cycle Docetaxel was stopped by treating physician. CME was completely resolved by three months. Several studies suggest that a cumulative dose seems necessary for the onset of the toxic effect of this drug. To our knowledge, we report the first case of Docetaxel-induced T-CME occurring within less than 1 month, with a very low cumulative dose. This suggests that no cumulative dose is needed for macular edema to appear.
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低累积剂量多西他赛诱发双侧囊样黄斑水肿:病例报告
多西他赛和紫杉醇属于类固醇类药物。它们是广泛使用的化疗药物,对各种类型的实体恶性肿瘤有效。多西他赛相关的双侧中毒性囊样黄斑水肿(T-CME)是一种罕见的不良反应。我们报告了一例使用多西他赛治疗乳腺癌并出现T-CME的43岁女性患者。她接受了两个周期的多西他赛 150 毫克、培妥珠单抗 420 毫克和曲妥珠单抗 360 毫克的治疗。第二个周期治疗三天后,她抱怨视力下降。她的双眼视力为 20/200。眼底检查显示黄斑水肿,SD-OCT 和荧光素血管造影证实了这一点。第四个疗程后,主治医生停用了多西他赛。三个月后,黄斑水肿完全消退。多项研究表明,这种药物的毒性作用似乎需要累积剂量才能产生。据我们所知,我们报告了首例多西他赛诱发T-CME的病例,患者在不到1个月的时间内就出现了T-CME,而且累积剂量非常低。这表明黄斑水肿的出现不需要累积剂量。
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