ニュウガン ジュツゼン カガク リョウホウ FECリョウホウ チュウ ニ モウマク ジョウミャク ヘイソクショウ ニ ヨル ヘンソクセイ ノ オウハン フシュ オ ハッショウシタ 1レイ

症例は60歳女性。検診で右乳癌が疑われ、精査により浸潤性乳管癌の診断となった。術前化学療法としてDTX療法(docetaxel)4サイクル終了後にFEC療法(5-FU+epirubicin+cyclophosphamide)を開始した。FEC療法2サイクル目投与中に、左眼の視力低下が出現し、翌日に左眼底に出血を伴う網膜静脈分枝閉塞症および嚢胞状黄斑浮腫を確認した。FEC療法を中止し、非ステロイド性抗炎症点眼薬(NSAIDS点眼薬)投与、抗血管内皮増殖因子抗体薬(抗VEGF抗体薬)の硝子体内注射による治療を開始した。その後も3か月毎に抗VEGF抗体薬投与を行ったところ、徐々に黄斑浮腫は改善、視力は治療開始 1 年後に回復した。これまでにタキサン系の抗癌剤で黄斑浮腫が出現した報告はあるが、FEC療法の副作用で黄斑浮腫が出現したとの報告はなく、本症例は希少な症例と考えられた。また、抗癌剤治療の際には眼副作用の予防、発症の早期検知、早期治療を心掛ける必要がある。The case is a 60-year-old woman. Right breast cancer was suspected during a medical checkup, and a close examination revealed a diagnosis of invasive ductal carcinoma of the breast. After 4 cycles of DTX (docetaxel) as neoadjuvant chemotherapy, FEC (5-FU + epirubicin + cyclophosphamide) was started. During the second cycle of FEC therapy, vision loss in the left eye appeared, and the next day, branch retinal vein occlusion with hemorrhage and cystoid macular edema were observed in the left fundus. FEC therapy was discontinued, and treatment with non-steroidal anti-inflammatory eye drops (NSAIDS eye drops) and intravitreal injection of anti-vascular endothelial growth factor antibody drug (anti-VEGF antibody drug) was started. After administration of anti-VEGF antibody drug every 3 months, macular edema gradually improved and visual acuity was restored one year after the start of treatment. Although there have been reports of macular edema caused by taxane-type anticancer drugs, there have been no reports of macular edema as a side effect of FEC therapy, and this case was considered to be a rare one. In addition, it is necessary to keep in mind the prevention of ocular side effects, early detection of their onset, and early treatment when anticancer drug therapy is used.departmental bulletin pape