Eye toxicity of cancer chemotherapy: A review of the literature

Griffin, James D.; Garnick, Marc B.

doi:10.1002/1097-0142(19811001)48:7<1539::aid-cncr2820480713>3.0.co;2-b

Cited by 77 publications

(27 citation statements)

References 87 publications

(9 reference statements)

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“…Radiation retinopathy is said to occur more severely in retinas already affected by microvascular processes such as diabetes mellitus (Amoaku & Archer 1990b;Viebahn et al 1991;Viebahn & Barracks 1993), and concurrent use of chemotherapeutic agents may potentiate the injurious effects by their effects on DNA synthesis and vascular endothelial cell repair and division (Brown et al 1981;Griffin & Garnick 1981).…”

Section: Radiotherapymentioning

confidence: 99%

Ocular presentations of breast cancer

Wickremasinghe

Dansingani

Tranos

et al. 2006

Acta Ophthalmologica Scandinavica

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IntroductionBreast cancer is the most common malignancy in women (Office of National Statistics 2002). As ophthalmic manifestations are common, the astute ophthalmologist can instigate the search for primary disease when the first presentation is ophthalmic in nature, or, alternatively, play an important role in detecting the metastatic spread of a known primary. Breast cancer accounts for 29% of new malignancies in women in the UK and is a major cause of mortality and morbidity worldwide.The purpose of this article is to provide a review of the ophthalmic manifestations of breast cancer. The subjects covered include the presenting features of metastatic disease involving the visual systems, treatment modalities and strategies currently available, and the ocular effects and complications of treatment. EpidemiologyIncidence rates of breast cancer have increased over the last decade, rising from 90 to 130 per 100 000 population (1988 versus 1998) (Office of National Statistics 2002). In contrast, mortality rates have remained relatively stable since the 1950s. This increase in the incidence of breast cancer is attributed to more effective screening programmes, although a change in the demographics of developed countries and an increasing elderly population may contribute to the growing incidence. Geographical variations exist in breast cancer incidence rates, with higher rates in Europe, North America and Oceania and lower rates in Asia and Africa (Sasco 2001). Doctors practising in the western world should be familiar with the disease.Male breast cancer is rare. The incidence is 0.8-1.5 cases per 100 000 male population, accounting for 1% of all breast cancer diagnoses (Office of National Statistics 2002; Hodgson et al. 2004). The highest incidence occurs in men aged over 70 years (Kidmas et al. 2005). In families with hereditary breast cancer, younger males may be affected. The BRCA2 gene is often implicated in these cases (Lorenzo Bermejo & Hemminki 2005).Ocular manifestations of male breast cancer can occur and this differential diagnosis should not be overlooked (O'Brien et al. 2000;Silvestris et al. 2003;Dieing et al. 2004). Ophthalmic metastases in breast cancerMetastatic disease to the eye from the breast was first described by Johann ABSTRACT.Context: Breast cancer is the most common malignancy in women, with increasing incidence in Europe and North America. The frequency of involvement of the eye and visual pathways is reported to be as high as 30% in patients with known metastatic disease. In some cases, ophthalmic involvement can be the first sign of metastatic spread. Metastasis occurs via the haematogenous route and predominantly involves the choroid. Metastases to other ocular structures, the orbit and the visual pathways have also been described. Paraneoplastic effects are rare but significant. Treatments: Different modalities are employed in the treatment of breast cancer and its metastases. These include chemotherapy and radiotherapy. The ocular adverse effects of these have been well described,...

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Section: Radiotherapymentioning

confidence: 99%

Ocular presentations of breast cancer

Wickremasinghe

Dansingani

Tranos

et al. 2006

Acta Ophthalmologica Scandinavica

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“…Vacuolization of myelinated central nervous system tissues have been reported with its use (16). Topical 5-FU has been found to cause conjunctivitis, blepharitis, circumorbital edema, ocular pain, and corneal ulceration (11,22). Subconjunctivally administered 5-FU has not produced significant side effects, and it penetrates well into the cornea, sclera, and choroid (20).…”

Section: Commentmentioning

confidence: 99%

“…Dox is active in all phases of the cell cycle (8,9). Side effects of systemically administered Dox include excessive lacrimation and conjunctivitis (11,12). Bleomycin (Bleo) is an antibiotic produced by Streptomyces verticilIus.…”

Section: Commentmentioning

confidence: 99%

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Effects of selected repeated intravitreal chemotherapeutic agents

et al. 1985

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The toxic effects of repeated intravitreal injections of selected chemotherapeutic agents were studied in female albino rabbits. Three groups of eyes participated in each therapeutic regimen. Agents studied were doxorubicin (dox), 3 and 5 micrograms; 5-fluorouracil (5-FU), 0.375 and 1.0 mg; bleomycin (bleo), 15 micrograms; thiotepa (thio), 12 micrograms; etoposide (VP-16), 150 micrograms; and methotrexate (MTX), 600 mic. Toxicity was evaluated using electroretinography (ERG) in 66% and histopathology in 100% of eyes 5 weeks following the initial injection and at least 2 weeks after the final injection of each series. Eyes receiving 2 doses of dox 3 micrograms showed no toxicity. Eyes receiving 3 or more doses of dox 3 micrograms and those treated with 2 or more doses of dox 5 demonstrated toxicity proportional to the number of doses received. Eyes treated with 5-FU 0.375 or 1.0 mg showed no toxic reaction. Successive intravitreal injections of 5-FU, 0.375 mg and dox 5 micrograms, and 5-FU, dox, and bleo produced no toxicity. Eyes treated with successive intravitreal injections of 5-FU, dox, bleo, and thio displayed decreased ERG response. The addition of VP-16 and MTX resulted in further loss of ERG response and more severe histologic retinal changes.

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“…Since the frequency of nephrotoxicity has been substantially reduced by hydration and diuresis, and since high doses of cisplatin have been implemented to enhance antitumor efficacy, neurotoxicity now represents a dose-limiting toxicity of the parent compound [12,15]. Neurologic manifestations of cisplatin toxicity include peripheral nerve demyelination and neuropathy [15], papilledema and retrobulbar neuritis [16], seizures [17], and others. Iproplatin-induced ototoxicity is probably less common than that induced by cisplatin, although this toxicity is seldom dose-limiting [12].…”

Section: Discussionmentioning

confidence: 99%

Phase I — Preliminary phase II trial of iproplatin, a cisplatin analogue

et al. 1988

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Iproplatin was administered intravenously over 30 min daily for 5 consecutive days every 3 weeks to 80 evaluable patients with a variety of refractory solid tumor malignancies. Thrombocytopenia was the dose-limiting toxicity. Reversible drug-induced renal dysfunction was observed in 3 patients. One patient sustained mild ototoxicity but neurotoxicity was not encountered. Transient neutropenia, anemia, nausea, vomiting, diarrhea, elevations of liver enzymes, alopecia, and skin rash also occurred. The spectrum and severity of toxicity of iproplatin were found to differ from those of cisplatin. The maximally tolerated dose (MTD) was 45 mg/m2/day in patients who received prior chemotherapy and 65 mg/m2/day in those who did not. No complete responses occurred. Partial responses were obtained in 2/15 patients with colon cancer, 3/18 with breast cancer, 2/4 with carcinoma of unknown primary site and 1/2 with pancreatic cancer. Thirteen patients with lung (5), breast (4), colon (2), head and neck (1) and cervical (1) cancers had stable disease. Based on the different toxicity profiles between iproplatin and cisplatin and the possible antitumor efficacy of the former, phase II investigation of iproplatin has been initiated.

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Eye toxicity of cancer chemotherapy: A review of the literature

Cited by 77 publications

References 87 publications

Ocular presentations of breast cancer

Ocular presentations of breast cancer

Effects of selected repeated intravitreal chemotherapeutic agents

Phase I — Preliminary phase II trial of iproplatin, a cisplatin analogue

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