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Jebrouni F, Bailal H, Omari M, Khater K, Bali A, Al Jarroudi O, Brahmi SA, Afqir S. Management of Cisplatin-Induced Encephalopathy: A Case Report and Literature Review. Cureus 2024; 16:e62176. [PMID: 38993468 PMCID: PMC11239081 DOI: 10.7759/cureus.62176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2024] [Indexed: 07/13/2024] Open
Abstract
Cisplatin is a cancer therapy drug commonly used. It is well-known for its antineoplastic properties, as well as for its numerous adverse effects, particularly its neurotoxicity. Symptoms associated with a central nervous system injury are unusual but can present a diagnostic challenge. Here, we report a case of a 62-year-old patient who was diagnosed with undifferentiated nasopharyngeal carcinoma. Cisplatin-based chemotherapy was administrated. Five days following the second cycle of treatment, the patient presented neurological disorders. A full biological workup and brain imaging were requested and revealed no abnormalities. The diagnosis of cisplatin encephalopathy was then suspected. Twenty days after cessation of cisplatin therapy, the neurological symptoms began to improve. Based on our case and a review of the literature, cisplatin-induced encephalopathy remains unusual. Its diagnosis is based on a combination of clinical, biological, and radiological criteria and requires the exclusion of other etiologies for neurological disorders in a patient being treated for cancer. Treatment is symptomatic and depends on stopping cisplatin therapy. These neurological adverse effects are often transitory and disappear without major repercussions.
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Affiliation(s)
| | - Hanan Bailal
- Medical Oncology, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University of Oujda, Oujda, MAR
| | - Mouhsine Omari
- Medical Oncology, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University of Oujda, Oujda, MAR
| | - Kaouthar Khater
- Medical Oncology, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University of Oujda, Oujda, MAR
| | - Asmae Bali
- Medical Oncology, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University of Oujda, Oujda, MAR
| | | | | | - Said Afqir
- Medical Oncology, Mohammed VI University Hospital, Oujda, MAR
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Luo Y, Cai B, Li B, Liu F, Du L, Zhao D, Fan W, Meng L, Zhang X, Ma L. The Acute Toxicities and Efficacy of Concurrent Chemotherapy With Docetaxel Plus Cisplatin, or Docetaxel, or Cisplatin and Helical Tomotherapy in Patients With Locoregionally Advanced Nasopharyngeal Carcinoma: A Randomized Single-Center Phase II Trial. Technol Cancer Res Treat 2022; 21:15330338221109974. [PMID: 35770295 PMCID: PMC9251964 DOI: 10.1177/15330338221109974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2022] Open
Abstract
Objective: The objective of this trial is to evaluate and compare the acute toxicity in patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC) treated with docetaxel plus cisplatin, or docetaxel, or cisplatin concurrently with helical tomotherapy during concurrent chemoradiotherapy (CCRT). Methods: In a prospective, single-center, open-label, randomized phase II study, after 2 cycles of induction chemotherapy with docetaxel plus cisplatin regimen, 125 patients with LA-NPC (stage III and IVA, UICC eighth) diagnosed pathologically from June 2017 to November 2019 were randomized into CCRT with docetaxel plus cisplatin group (25 patients), CCRT with docetaxel group (50 patients), and CCRT with cisplatin group (50 patients). The incidence of grade 3 or 4 acute toxicities and clinical efficacy were analyzed among the 3 groups. Results: Safety evaluation was completed in all the 125 patients, during the CCRT period, 66.4% of patients completed 3 cycles of chemotherapy, 24.0% completed 2 cycles of chemotherapy, and 9.6% completed 1 cycle of chemotherapy according to the research plan. The incidence of grade 3 or 4 acute toxicity in CCRT with docetaxel plus cisplatin (DP), docetaxel (D), and cisplatin (P) groups was 88.0%, 72.0%, and 56.0%, respectively. The incidence of grade 3 or 4 acute toxicities in the DP group was significantly higher than that in the D and P groups (P = .015), no significant difference was detected between the D and P groups (P = .096). The most common toxicities were mucositis (40.0%), leukopenia (29.6%), neutropenia (26.4%), and pharyngo-esophagitis (12.0%); compared to D and P groups, DP group did not significantly improved the 3-year overall survival (96.0% vs 87.0% and 87.6%), progression-free survival (92.0% vs 79.7% and,76.9%), locoregional failure-free survival (96.0% vs 91.8% and 92.7%), and distant failure-free survival (100% vs 90.0% and 89.0%), there were no significant difference in survival data among the 3 groups (all P > .05). Conclusions: Higher survival benefits did not achieve from intensified CCRT with DP, CCRT with P or D obtained similar short-term survival outcomes with similar acceptable toxicities in LA-NPC patients.
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Affiliation(s)
- Yanrong Luo
- Medical School of Chinese PLA, Beijing, China.,Department of Radiation Oncology, 104607First Medical Center of Chinese PLA General Hospital, Beijing, China.,Department of Radiation Oncology, Hainan Hospital of Chinese PLA General Hospital, Sanya, China
| | - Boning Cai
- Department of Radiation Oncology, 104607First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Bo Li
- Department of Cardiology, Hainan Hospital of Chinese PLA General Hospital, Sanya, China
| | - Fang Liu
- Department of Radiation Oncology, 104607First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Lei Du
- Department of Radiation Oncology, Hainan Hospital of Chinese PLA General Hospital, Sanya, China
| | - Dawei Zhao
- Department of Radiation Oncology, 104607First Medical Center of Chinese PLA General Hospital, Beijing, China.,Department of Radiology, Pingjin Hospital, Characteristic Medical Center of Chinese People's Armed Police Force, Tianjin, China
| | - Wenjun Fan
- Department of Radiation Oncology, 104607First Medical Center of Chinese PLA General Hospital, Beijing, China.,Armed Police Forces Corps Hospital of Henan Province, Zhengzhou, China
| | - Linlin Meng
- Department of Radiation Oncology, 104607First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xinxin Zhang
- Department of Otolaryngology, 104607First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Lin Ma
- Department of Radiation Oncology, 104607First Medical Center of Chinese PLA General Hospital, Beijing, China
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Pan R, Wang J, Qi F, Liu R. Dosimetric comparison and observation of three-dimensional conformal radiotherapy for recurrent nasopharyngeal carcinoma. Oncol Lett 2017; 14:4741-4745. [PMID: 28943965 PMCID: PMC5594253 DOI: 10.3892/ol.2017.6732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 06/21/2017] [Indexed: 11/16/2022] Open
Abstract
The aim of the study was to investigate the effect of three-dimensional conformal radiation therapy (3D-CRT) on nasopharyngeal carcinoma (NPC) and the incidence of complications. Between May 2010 and June 2012, 141 patients diagnosed with local recurrence of NPC due to cranial base lesions or cranial nerve symptoms, confirmed by pathology biopsy and/or by CT/MRI, were included in the present study. In accordance with the principle of randomized control, the patients were divided into three groups and treated with three different doses of 3D-CRT. The planned radiotherapy doses of 3D-CRT were 58/1.8–2 Gy, 62/1.8–2 Gy and 68/1.8–2 Gy, respectively. The survival rate, disease-free survival (DFS) rate and local control rate of the three groups of patients were compared as well as the adverse reactions observed after radiotherapy. The prognoses of NPC patients were analyzed by univariate and multivariate analyses. The follow-up rate of the study was 100%. The 5-year overall survival, DFS, and locoregional recurrence-free survival rates were: 43.2 vs. 64.53 vs. 75%, 29.13 vs. 42.82 vs. 39.7% and 30.76 vs. 44.19 vs. 45.4%, respectively. In addition, 62/1.8–2 Gy was similar in treatment effects to 68/1.8–2 Gy, but 68/1.8–2 Gy showed more adverse reactions than 62/1.8–2 Gy. Thus, 62/1.8–2 Gy can be used as a safe and effective dose for 3D-CRT treatment of NPC. Univariate and multivariate analyses showed that age may be the main prognostic factor of patients with NPC. In conclusion, 3D-CRT with a dose of 62/1.8–2 Gy is a safe, effective and tolerable treatment for NPC patients with good clinical value.
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Affiliation(s)
- Rongqiang Pan
- Cancer Center, Nanchong Central Hospital, Nanchong, Sichuan 637000, P.R. China
| | - Jingming Wang
- Department of Ear, Nose and Throat, Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu 730050, P.R. China
| | - Feng Qi
- Department of Radiotherapy, The First People's Hospital of Shangqiu, Shangqiu, Henan 476100, P.R. China
| | - Ruizhen Liu
- Department of Radiotherapy, The First People's Hospital of Shangqiu, Shangqiu, Henan 476100, P.R. China
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