Mitomycin-induced pulmonary toxicity: case report and review of the literature.
OBJECTIVE
This report describes a case of mitomycin-induced pulmonary toxicity and reviews the incidence of this adverse effect, reported patterns of toxicity and associated dosages of the drug, and the use of corticosteroids in the management of pulmonary toxicity.


METHODS
Information about our patient was obtained in part from the medical chart; we had also treated him personally in the past. We conducted a MEDLINE search of the English language literature (restricted to human studies) from 1966 to 1991 and manually searched Index Medicus for current information.


METHODS
All case reports that described pulmonary toxicity possibly associated with mitomycin were reviewed.


METHODS
Studies were evaluated for the dosages of mitomycin given to patients, the nature and onset of symptoms, management course, and corticosteroid use.


RESULTS
Our case is similar to others described in the literature. The incidence of mitomycin-induced pulmonary toxicity has been reported to range from 2 to 38 percent. Concurrent vinca alkaloid administration may potentiate the risk of an acute pulmonary insult secondary to mitomycin use. The toxicity is usually of slow onset and the average total dosage of drug implicated is 78 mg. A formal evaluation of corticosteroid treatment has not been performed, but various authors have reported success with different regimens.


CONCLUSIONS
The incidence of pulmonary toxicity associated with mitomycin is unpredictable, but more likely to occur at higher dosages. Treatment with corticosteroids is encouraged to improve pulmonary response.
Linette
D C
DC
College of Pharmacy, School of Medicine, University of South Carolina, Columbia.
McGee
K H
KH
McFarland
J A
JA
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D008937:Mitomycins / Q000008:administration & dosage / Q000009:adverse effects*; D011859:Radiography
D000305:Adrenal Cortex Hormones; D008937:Mitomycins