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167 Drug-induced encephalopathy in cervical cancers treated with ifosfamide: a case series and review of literature
  1. M Febiani and
  2. ING Budiana
  1. Sanglah General Hospital, Obstetric and Gynecologic, Denpasar – Bali, Indonesia


Objectives The incidence of cervical cancer in Indonesia ranks fourth with 17 per 100,000. Ifosfamide has been used for end-stage cervical cancer and recurrent cases, but this drug is associated with various side effects. Ifosfamid-induced neurotoxicity can be cranial nerve paralysis, to acute enchepalopathy and reversible posterior encephala syndrome. Until now, the incidence of ifosfamid neurotoxicity in our centers and how much this has affected patients is unknown. In this study we presented a series of encephalopathy cases found in cervix cancer patients who received ifosfamid chemotherapy.

Methods Retrospective study, study population are all cervical cancer patient who received ifosfamid chemotherapy from 2015–2017. There are five patients, we observed the onset of encephalopathy, diagnosed is enforced by neurologists using Meanwell criteria.

Results Five patients received ifosfamide - cisplatin chemotherapy, with differences initial condition, so that patient outcomes are different. Chemotherapy was given in one to six series, depending on the patient‘s response. Side effects such as encephalopathy appeared in four patients, while one patient managed to ‘recover’ and proven by pap smear test (no evidence of malignancy cell.

Conclusions Ifosfamid encepalopathy is a side effect that needs to be watched with symptoms that are diverse, but generally mild an in some cases can be progressive and fatale. Analysis of patient risk factors, patient education, and preparation for management of encepalopathy should be carried out in all cases who will receive ifosfamid. Methylene blue and thiamine can be a prophylactic and therapeutic choice in this condition.

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