Nitrosourea derivatives-induced pulmonary toxicity in patients treated for malignant brain tumors. Early subclinical detection and its prevention.
Nitrosourea derivatives, such as BCNU and CCNU, are considered useful chemotherapeutic agents in malignant brain tumors combined therapy. Pulmonary toxicity is one of the major side effects demonstrated both in experimental animal models and in human autoptic findings. Pulmonary fibrosis is the end point of progressive functional disorder of respiratory mechanism and alveolo-capillary gas exchanges. Authors present the results of a randomized, double-blind trial of 40 patients previously treated with surgery and radiotherapy and who subsequently underwent BCNU therapy for primary intracranial glioma. Patients underwent functional respiratory examinations at each chemotherapy course interval. Twenty patients received ambroxol (120 mg/day) for 40 days after chemotherapy course. Control patients received placebo with the same schedule and showed a significant reduction of pulmonary functional parameters (DLCO, MMEF, MEF 25%), whereas in the treated group there is no significant variation of these functional parameters. The mechanism of ambroxol is commonly related to the surfactant synthesis enhancement and to the action on bronchiolar pathways.
Gaetani
P
P
Silvani
V
V
Butti
G
G
Spanu
G
G
Rossi
A
A
Knerich
R
R
D000328:Adult; D000368:Aged; D000551:Ambroxol / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy*; D001964:Bromhexine / Q000031:analogs & derivatives*; D002330:Carmustine / Q000009:adverse effects*; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D005910:Glioma / Q000188:drug therapy*; D006801:Humans; D008875:Middle Aged; D011658:Pulmonary Fibrosis / Q000139:chemically induced / Q000503:physiopathology / Q000517:prevention & control*; D012129:Respiratory Function Tests
D000551:Ambroxol; D001964:Bromhexine; D002330:Carmustine