1.Pulmonary Toxicity after a Quick Course of Combinatorial Vincristine, Bleomycin, and Cisplatin Neoadjuvant Chemotherapy in Cervical Cancer.
Kyung Do KI ; Jong Min LEE ; Seon Kyung LEE ; Seo Yun TONG ; Chu Yeop HUH ; Jung Kyu RYU ; Kyo Young KIM
Journal of Korean Medical Science 2010;25(2):240-244
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.
Aged
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Antineoplastic Combined Chemotherapy Protocols/administration & dosage/*adverse effects/therapeutic use
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Bleomycin/administration & dosage/*adverse effects/therapeutic use
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Cisplatin/administration & dosage/*adverse effects/therapeutic use
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Female
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Humans
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Lung Diseases/*chemically induced/pathology
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Middle Aged
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*Neoadjuvant Therapy
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Pulmonary Fibrosis/chemically induced/mortality/pathology
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Retrospective Studies
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Tomography, X-Ray Computed
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Uterine Cervical Neoplasms/complications/*drug therapy
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Vincristine/administration & dosage/*adverse effects/therapeutic use