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Docetaxel Fluid Retention — SCE Medical Oncology MCQ

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ModerateOncological EmergenciesDocetaxel Fluid RetentionSCE Medical Oncology

A 55-year-old woman receiving docetaxel for breast cancer develops bilateral lower limb oedema, weight gain and pleural effusions after her third cycle. She has no DVT and cardiac function is normal. What is the most likely cause?

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Correct answer: D — Docetaxel-induced fluid retention syndrome — a cumulative dose-dependent adverse effect caused by capillary leak

Docetaxel causes a characteristic cumulative fluid retention syndrome (oedema, weight gain, pleural effusions, ascites) through capillary permeability changes. Risk increases with cumulative dose (>400 mg/m²). Prevention with dexamethasone premedication (8 mg BD for 3 days starting the day before docetaxel) significantly reduces severity. Management includes diuretics and dexamethasone dose optimisation. Dose reduction or treatment discontinuation may be needed for severe cases. This effect is less common with paclitaxel.

Reference: BNF Docetaxel; ESMO Supportive Care; TAX 327