内容紹介
A Retrospective Analysis of Eye Disorders Due to Oxaliplatin
Summary
In recent years, the incidence of eye disorders due to antineoplastic agents such as S-1 has increased. Eye disorders including visual field defect, visual field impairment, optic neuritis, and visual acuity reduction have been reported as serious adverse effects of oxaliplatin, an agent that is frequently used as a standard therapy for colorectal cancer. However, specific details about these conditions, such as the timing relative to oxaliplatin administration and frequencies at which they appear, remain to be clarified; therefore, we conducted a retrospective analysis of patients with eye disorders due to oxaliplatin in order to obtain evidence that would be useful in routine medical practice. Of the 55 patients who were treated with oxaliplatin in this analysis 10(18.2%)presented with eye disorders, including blepharoptosis(5 patients, 9.1%), visual field impairment(2 patients, 3.6%), visual acuity reduction(2 patients, 3.6%), eye pain(1 patient, 1.8%), congestion(1 patient, 1.8%), watering eyes(1 patient, 1.8%), and blurred vision(1 patient, 1.8%). These symptoms appeared during the early period of treatment, such as after the first or the second dose. We found that all patients had mild symptoms(Grade 1 or 2), and most improved spontaneously. Thus, eye disorders due to oxaliplatin affect Japanese patients somewhat frequently, although the symptoms are reversible and are mild in most cases. Detailed studies that include data from a larger number of facilities should be conducted in the future.
要旨
近年,S-1に代表されるように抗悪性腫瘍薬による眼障害が問題となっている。oxaliplatinは大腸がんの標準治療において汎用されている抗悪性腫瘍薬であり,重大な副作用として,視野欠損,視野障害,視神経炎,視力低下などの眼障害も報告されている。しかしながら,発現時期や発現頻度など未だ不明な点が多いのが現状である。そこで日常診療における有益な知見を得るため,oxaliplatinの眼障害に関する後方視的な調査を実施した。本検討期間でoxaliplatinが投与された全患者55名のうち,眼障害が発現した患者は10名(18.2%)であった。内訳は眼瞼下垂5名(9.1%),視野障害2名(3.6%),視力低下2名(3.6%),眼痛1名(1.8%),充血1名(1.8%),流涙1名(1.8%)および霧視1名(1.8%)であった。発現時期は初回や2回目などの治療初期が多く,症状の程度はいずれもGrade 1または2で比較的軽度であった。また,多くの症例が自然経過にて症状の改善を認めた。以上より,oxaliplatinによる眼障害は可逆的で軽微な症状が大半を占めるものの,本邦においてもある程度の頻度で存在していることが明らかとなった。今後,より多くの施設で詳細な検討を行われることが望まれる。
目次
Summary
In recent years, the incidence of eye disorders due to antineoplastic agents such as S-1 has increased. Eye disorders including visual field defect, visual field impairment, optic neuritis, and visual acuity reduction have been reported as serious adverse effects of oxaliplatin, an agent that is frequently used as a standard therapy for colorectal cancer. However, specific details about these conditions, such as the timing relative to oxaliplatin administration and frequencies at which they appear, remain to be clarified; therefore, we conducted a retrospective analysis of patients with eye disorders due to oxaliplatin in order to obtain evidence that would be useful in routine medical practice. Of the 55 patients who were treated with oxaliplatin in this analysis 10(18.2%)presented with eye disorders, including blepharoptosis(5 patients, 9.1%), visual field impairment(2 patients, 3.6%), visual acuity reduction(2 patients, 3.6%), eye pain(1 patient, 1.8%), congestion(1 patient, 1.8%), watering eyes(1 patient, 1.8%), and blurred vision(1 patient, 1.8%). These symptoms appeared during the early period of treatment, such as after the first or the second dose. We found that all patients had mild symptoms(Grade 1 or 2), and most improved spontaneously. Thus, eye disorders due to oxaliplatin affect Japanese patients somewhat frequently, although the symptoms are reversible and are mild in most cases. Detailed studies that include data from a larger number of facilities should be conducted in the future.
要旨
近年,S-1に代表されるように抗悪性腫瘍薬による眼障害が問題となっている。oxaliplatinは大腸がんの標準治療において汎用されている抗悪性腫瘍薬であり,重大な副作用として,視野欠損,視野障害,視神経炎,視力低下などの眼障害も報告されている。しかしながら,発現時期や発現頻度など未だ不明な点が多いのが現状である。そこで日常診療における有益な知見を得るため,oxaliplatinの眼障害に関する後方視的な調査を実施した。本検討期間でoxaliplatinが投与された全患者55名のうち,眼障害が発現した患者は10名(18.2%)であった。内訳は眼瞼下垂5名(9.1%),視野障害2名(3.6%),視力低下2名(3.6%),眼痛1名(1.8%),充血1名(1.8%),流涙1名(1.8%)および霧視1名(1.8%)であった。発現時期は初回や2回目などの治療初期が多く,症状の程度はいずれもGrade 1または2で比較的軽度であった。また,多くの症例が自然経過にて症状の改善を認めた。以上より,oxaliplatinによる眼障害は可逆的で軽微な症状が大半を占めるものの,本邦においてもある程度の頻度で存在していることが明らかとなった。今後,より多くの施設で詳細な検討を行われることが望まれる。