背景:用作癌症治疗的分子靶向药物可引起一些罕见和严重的不良事件,例如,伤口愈合延迟。根据使用的抗癌药物,建议在手术前后暂时停药,以避免并发症.一旦手术切口完全愈合并闭合,由于分子靶向治疗在手术后数月至数年开始,伤口很少开放。这里,我们的目的是描述两名患者的咽部皮肤瘘的罕见并发症,该并发症被认为是由分子靶向治疗引起的。
方法:病例1涉及一名64岁的亚洲男子,他在喉癌全喉切除术后3个月出现迟发性咽部皮肤瘘。Ramucirumab,一种用于复发性胃癌的血管内皮生长因子受体抑制剂,被推测参与其中。病例2涉及一名71岁的日本男子,他在咽癌全咽喉切除术2年零1个月后出现了延迟的咽皮肤瘘。据推测伊马替尼,用于慢性粒细胞白血病的血小板衍生生长因子受体α抑制剂,参与其中。
结论:尽管晚期药物引起的吻合口漏的发生率很低,当它发生时,它使长期口服不可能,并干扰适当的癌症治疗。在这份报告中,我们展示了这两名罕见并发症患者的细节,这可能有助于积累关于这个主题的基本数据。
BACKGROUND: Molecular-targeted agents used as a treatment for cancer can cause some rare and serious adverse events such as, delayed wound healing. Depending on the anticancer drug used, temporary withdrawal may be recommended before and after surgery to avoid complications. Once a surgical incision has healed and closed completely, wounds rarely open because of the initiation of molecular targeted therapy several months to years after surgery. Here, we aimed to describe a rare complication of pharyngocutaneous fistula in two patients that was thought to be caused by molecular targeted therapy.
METHODS: Case 1 involved a 64-year-old asian man who developed a delayed pharyngocutaneous fistula 3 months after total laryngectomy for laryngeal cancer. Ramucirumab, a vascular endothelial growth factor receptor inhibitor used for recurrent gastric cancer, was speculated to be involved.
Case 2 involved a 71-year-old japanese man who developed a delayed pharyngocutaneous fistula 2 years and 1 month after total pharyngeal laryngectomy for pharyngeal cancer. It was speculated that imatinib, a platelet-derived growth factor receptor alpha inhibitor used for chronic myeloid leukemia, was involved.
CONCLUSIONS: Although the incidence of late drug-induced anastomotic leakage is very low, when it occurs, it makes oral intake impossible for an extended period and interferes with the appropriate cancer treatment. In this report, we demonstrate the details of these two patients with such a rare complication, which may help accumulate essential data on this topic.