Radiation-induced lung fibrosis after treatment of small cell carcinoma of the lung with very high-dose cyclophosphamide.
Twenty-five previously untreated patients with small cell carcinoma of the lung were treated with cyclophosphamide 160 to 200 mg/kg (with autologous bone marrow support) followed by radiotherapy (4000 cGy) to the primary site and mediastinum. No other treatment was given until relapse occurred. Nineteen patients were assessable at least 4 months after radiotherapy; of these, 15 (79%) developed radiologic evidence of fibrosis, which was symptomatic in 14 (74%). The time of onset of fibrosis was related to the volume of lung irradiated. A retrospective analysis was made of 20 consecutive patients treated with multiple-drug chemotherapy and an identical radiotherapy regimen as part of a randomized trial. Radiologic and symptomatic fibrosis was one half as frequent (35%) as in the high-dose cyclophosphamide group. Very high-dose cyclophosphamide appears to sensitize the lung to radiotherapy and promotes the production of fibrosis.
Trask
C W
CW
Joannides
T
T
Harper
P G
PG
Tobias
J S
JS
Spiro
S G
SG
Geddes
D M
DM
Souhami
R L
RL
Beverly
P C
PC
D000328:Adult; D000368:Aged; D018288:Carcinoma, Small Cell / Q000628:therapy*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011658:Pulmonary Fibrosis / Q000209:etiology*; D011832:Radiation Injuries / Q000209:etiology; D011838:Radiation-Sensitizing Agents; D011878:Radiotherapy / Q000009:adverse effects*
D011838:Radiation-Sensitizing Agents; D003520:Cyclophosphamide