Pulmonary epithelial permeability in patients treated with bleomycin containing chemotherapy detected by technetium-99m diethylene triamine penta-acetic acid aerosol (99mTc-DTPA) scintigraphy.
OBJECTIVE
To evaluate pulmonary epithelial permeability using 99mTc-DTPA scintigraphy in patients treated with bleomycin-containing regimens.


METHODS
Twelve non-smoking chemotherapy-naïve patients with no clinical or radiological evidence of pulmonary disease and treated with bleomycin-containing chemotherapy were tested with 99mTc-DTPA scintigraphy before the first cycle and every 3 weeks until the third month after the end of chemotherapy (total cumulative dose of bleomycin 347.9 mg).


RESULTS
Pretreatment values (T1/2 74.93 minutes) of 99mTc-DTPA scintigraphy were significantly higher than those obtained after the total dose of bleomycin (T1/2 51.00 minutes) (p < 0.001). This difference was more important in the later evaluations especially, on the third week and third month measures after discontinuing treatment (p < 0.001). All the tests of Within-Subjects Effects were significant (p < 0.001). Comparing pretreatment and post-treatment scintigraphies the mean T1/2 99mTc-DTPA values decreased as the bleomycin dose increased.


CONCLUSIONS
We conclude that cumulative bleomycin doses are related to increased pulmonary epithelial permeability at a dose of 256.5 mg. However, whether this is related to clinical toxicity is uncertain and large, multi-center prospective studies are needed.
de Azambuja
Evandro
E
Department of Clinical Oncology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil. e_brussels@hotmail.com
Fleck
James Freitas
JF
Barreto
Sérgio Saldanha Menna
SS
Cunha
Rentato Duarte
RD
D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects / Q000627:therapeutic use; D001761:Bleomycin / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy; D006801:Humans; D008297:Male; D010051:Ovarian Neoplasms / Q000188:drug therapy; D010539:Permeability / Q000187:drug effects; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D020545:Respiratory Mucosa / Q000000981:diagnostic imaging* / Q000187:drug effects* / Q000378:metabolism; D016284:Technetium Tc 99m Pentetate / Q000493:pharmacokinetics; D013736:Testicular Neoplasms / Q000188:drug therapy
D000903:Antibiotics, Antineoplastic; D019275:Radiopharmaceuticals; D001761:Bleomycin; D016284:Technetium Tc 99m Pentetate