{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1390573593431232512.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.11334/jibi.67.3_193"}},{"identifier":{"@type":"URI","@value":"https://search.jamas.or.jp/link/ui/2021270935"}}],"dc:title":[{"@language":"en","@value":"A case of rhabdomyolysis after nivolumab treatment for hypopharyngeal carcinoma"},{"@language":"ja","@value":"再発転移下咽頭癌に対しニボルマブ投与後に発症した横紋筋融解症の 1 例"}],"dc:language":"ja","description":[{"type":"abstract","notation":[{"@language":"en","@value":"<p>A 62-year-old man who was initially diagnosed with Stage IVa squamous cell cancer of the hypopharynx, received concurrent chemoradiotherapy with cisplatin. As local recurrence was subsequently observed, he underwent total laryngopharyngectomy with free flap reconstruction. However, unresectable cervical lymph node metastasis was observed 3 months after the surgery. He was therefore treated with nivolumab as first-line therapy. As disease progression was observed after 4 courses of nivolumab, he was then treated with paclitaxel plus cetuximab as second-line therapy. He suddenly lost consciousness at home 2 days after 8 courses of the chemotherapy (11 months after the first administration of nivolumab). As elevated CK was observed in the laboratory test on admission, immune-related adverse events were initially suspected. The patient died without showing a response to steroid therapy, ventilator management, continuous hemodiafiltration and other treatments. The autopsy revealed a lack of cross-striation of skeletal muscle, indicating the existence of rhabdomyolysis. Although there have been few reports on rhabdomyolysis after nivolumab treatment date, this immune-related adverse events (irAEs) may be a potentially fatal adverse event.</p>"},{"@language":"ja","@value":"<p>症例は 62 歳、男性。下咽頭癌に対し化学放射線治療を施行後、局所再発を認め、咽頭喉頭頸部食道摘出術を施行した。その後根治切除不能な頸部リンパ節転移を認め、一次薬物治療としてニボルマブを導入したが、計 4 回投与後に撮影した CT で progressive disease の判定となった。二次治療の化学療法施行中に意識障害を発症し、救急搬送となり、入院後 CK の上昇と腎機能障害を認めた。人工呼吸器管理、持続的血液濾過透析を施行しステロイド投与等の治療を行ったが奏功せずに死亡された。病理解剖では横紋筋の融解および変性の所見を認め、横紋筋融解症の診断に至った。ニボルマブ投与後に横紋筋融解症を来した症例報告は少ないが、致死的な有害事象となり得る可能性があり、慎重な経過観察が必要であると考える。</p>"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410573593431232517","@type":"Researcher","foaf:name":[{"@language":"en","@value":"INAMO Mana"},{"@language":"ja","@value":"稲毛 まな"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Otorhinolaryngology, Kanagawa Children's Medical Center"},{"@language":"ja","@value":"神奈川県立こども医療センター耳鼻咽喉科"},{"@language":"en","@value":"Department of 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KAI"},{"@language":"ja","@value":"耳鼻と臨床会"}],"prism:publicationDate":"2021-05-20","prism:volume":"67","prism:number":"3","prism:startingPage":"193","prism:endingPage":"199"},"url":[{"@id":"https://search.jamas.or.jp/link/ui/2021270935"}],"availableAt":"2021-05-20","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=%E5%85%8D%E7%96%AB%E3%83%81%E3%82%A7%E3%83%83%E3%82%AF%E3%83%9D%E3%82%A4%E3%83%B3%E3%83%88%E9%98%BB%E5%AE%B3%E8%96%AC","dc:title":"免疫チェックポイント阻害薬"},{"@id":"https://cir.nii.ac.jp/all?q=%E3%83%8B%E3%83%9C%E3%83%AB%E3%83%9E%E3%83%96","dc:title":"ニボルマブ"},{"@id":"https://cir.nii.ac.jp/all?q=%E8%87%AA%E5%B7%B1%E5%85%8D%E7%96%AB%E9%96%A2%E9%80%A3%E6%9C%89%E5%AE%B3%E4%BA%8B%E8%B1%A1","dc:title":"自己免疫関連有害事象"},{"@id":"https://cir.nii.ac.jp/all?q=%E6%A8%AA%E7%B4%8B%E7%AD%8B%E8%9E%8D%E8%A7%A3%E7%97%87","dc:title":"横紋筋融解症"},{"@id":"https://cir.nii.ac.jp/all?q=%E4%B8%8B%E5%92%BD%E9%A0%AD%E7%99%8C","dc:title":"下咽頭癌"}],"dataSourceIdentifier":[{"@type":"JALC","@value":"oai:japanlinkcenter.org:2009338238"}]}