Successful chemotherapy for small-cell lung cancer in an elderly patient undergoing continuous ambulatory peritoneal dialysis
| Autor: | Mitsuko Sugimura, Minoru Sakuramoto, Eisaku Tanaka, Noriko Okumura, Toshifumi Nakajima, Kohei Ikezoe, Yusuke Kaji, Kiminobu Tanizawa, Takashi Hajiro, Yoshio Taguchi, Seishu Hashimoto, Eizaburo Sato, Takehiro Yasuda, Masayoshi Minakuchi, Kentaro Fukunaga |
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| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Peritoneal dialysis Carboplatin chemistry.chemical_compound Peritoneal Dialysis Continuous Ambulatory Antineoplastic Combined Chemotherapy Protocols Internal Medicine medicine Humans Lung cancer Etoposide Aged Chemotherapy business.industry Continuous ambulatory peritoneal dialysis Age Factors General Medicine medicine.disease Small Cell Lung Carcinoma Surgery Treatment Outcome chemistry Hemodialysis business Chemoradiotherapy medicine.drug |
| Zdroj: | Internal medicine (Tokyo, Japan). 49(12) |
| ISSN: | 1349-7235 |
| Popis: | A standard treatment has not yet been established for elderly small-cell lung cancer patients, especially when they have end-stage renal disease. We report the first case of successful chemoradiotherapy in an elderly small-cell lung cancer patient undergoing continuous ambulatory peritoneal dialysis. A 77-year-old Japanese man on continuous ambulatory peritoneal dialysis was diagnosed as having limited disease small-cell lung cancer. He received four monthly cycles of chemotherapy consisting of carboplatin at 240 mg/m(2) on day 1 and etoposide at 40 mg/m(2) on days 1 and 3. He underwent additional hemodialysis on days 1 and 3, while continuous ambulatory peritoneal dialysis continued as usual on the other days. Following chemotherapy, he underwent hyperfractionated radiotherapy to a total dose of 45 Grey, resulting in complete remission of the disease. A pharmacokinetic study showed an area under the concentration-time curve of carboplatin of 3.41 to 4.88 mg.min/mL, increasing gradually over the first three cycles, while etoposide did not show this gradual increase. The increased area under the concentration-time curve of carboplatin may have reflected a worsened renal function during chemotherapy. Despite dose reductions and favorable areas under the concentration-ime curve of carboplatin, the patient suffered grade 3-4 hematological toxicities, necessitating transfusions and a further dose reduction. The patient died of recurrent small-cell lung cancer 19 months after diagnosis. |
| Databáze: | OpenAIRE |
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