Canalicular stenosis secondary to docetaxel (Taxotere) - A newly recognized side effect

Objective: To report a newly recognized side effect of a commonly used anti neoplastic agent, docetaxel, in three patients with metastatic breast cance r. Design: Observational case reports. Participants: Three patients with metastatic breast cancer who received wee kly docetaxel chemotherapy. Main Outcome Measures: Occurrence of epiphora and severity of punctal and c analicular fibrosis secondary to docetaxel. Results: In three patients receiving weekly docetaxel, canalicular stenosis and resultant epiphora developed shortly after start of their treatment. D iscontinuation of drug several months after initiation of therapy did not l ead to resolution of symptoms in two of the three patients. Conclusions: Epiphora is a newly recognized side effect of docetaxel and ma y occur more frequently with weekly cycles of this drug. The mechanism for epiphora seems to be punctal and canalicular stenosis, This side effect, in advanced cases, is not reversible with discontinuation of the drug. Patien ts being administered weekly cycles of:docetaxel should be screened for epi phora and canalicular stenosis, and treatment in the form of silicone intub ation or punctoplasty should be considered in early stages to prevent the n eed for conjunctivo-dacryocystorhinostomy. Ophthalmology 2001;108:994-995 ( C) 2001 by the American Academy of Ophthalmology.