Pulmonary Toxicity after a Quick Course of Combinatorial Vincristine, Bleomycin, and Cisplatin Neoadjuvant Chemotherapy in Cervical Cancer.
10.3346/jkms.2010.25.2.240
- Author:
Kyung Do KI
1
;
Jong Min LEE
;
Seon Kyung LEE
;
Seo Yun TONG
;
Chu Yeop HUH
;
Jung Kyu RYU
;
Kyo Young KIM
Author Information
1. Department of Obstetrics and Gynecology, East-West Neo Medical Center, Kyung Hee University, Seoul, Korea. kgo02@hanmail.net
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Uterine Cervical Neoplasms;
Neoadjuvant Therapy;
Bleomycin;
Drug Toxicity
- MeSH:
Aged;
Antineoplastic Combined Chemotherapy Protocols/administration & dosage/*adverse effects/therapeutic use;
Bleomycin/administration & dosage/*adverse effects/therapeutic use;
Cisplatin/administration & dosage/*adverse effects/therapeutic use;
Female;
Humans;
Lung Diseases/*chemically induced/pathology;
Middle Aged;
*Neoadjuvant Therapy;
Pulmonary Fibrosis/chemically induced/mortality/pathology;
Retrospective Studies;
Tomography, X-Ray Computed;
Uterine Cervical Neoplasms/complications/*drug therapy;
Vincristine/administration & dosage/*adverse effects/therapeutic use
- From:Journal of Korean Medical Science
2010;25(2):240-244
- CountryRepublic of Korea
- Language:English
-
Abstract:
Pulmonary toxicity is one of the most serious adverse effects associated with a quick course of vincristine, bleomycin, and cisplatin neoadjuvant chemotherapy (NAC-VBP). The aim of this study was to evaluate pulmonary toxicity related to a quick course NAC-VBP. A total of consecutive 61 patients, who underwent at most 3 cycles of NAC-VBP every 10 days in the International Federation of Gynecology and Obstetrics (FIGO) stage IB-IIB cervical cancer from 1995 to 2007, were retrospectively analyzed. Of the 61 study subjects, 7 (11.5%) were identified to have pulmonary toxicity and 2 (3.3%) died of pulmonary fibrosis progression despite aggressive treatment and the use of a multidisciplinary approach. No factor predisposing pulmonary toxicity was identified. Initial symptoms were non-specific, but bronchiolitis obliterans organizing pneumonia and interstitial pneumonitis were characteristic findings by high-resolution computed tomography of the chest. The benefit of steroid therapy was uncertain and was associated with steroid-induced diabetes mellitus requiring insulin therapy in two patients. Fatal pulmonary toxicity is a major concern of a quick course NAC-VBP. In conclusion, these patients require special monitoring for bleomycin-induced pulmonary toxicity.
