title: Successful chemotherapy for small-cell lung cancer in an elderly patient undergoing continuous ambulatory peritoneal dialysis.
abstract: 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.
authors.affiliation: Department of Respiratory Medicine, Tenri Hospital, Tenri, Japan. tanizawa@kuhp.kyoto-u.ac.jp
authors.forename: Kiminobu
authors.initials: K
authors.lastname: Tanizawa
authors.forename: Kentaro
authors.initials: K
authors.lastname: Fukunaga
authors.forename: Noriko
authors.initials: N
authors.lastname: Okumura
authors.forename: Mitsuko
authors.initials: M
authors.lastname: Sugimura
authors.forename: Eisaku
authors.initials: E
authors.lastname: Tanaka
authors.forename: Takashi
authors.initials: T
authors.lastname: Hajiro
authors.forename: Minoru
authors.initials: M
authors.lastname: Sakuramoto
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Minakuchi
authors.forename: Seishu
authors.initials: S
authors.lastname: Hashimoto
authors.forename: Takehiro
authors.initials: T
authors.lastname: Yasuda
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kaji
authors.forename: Kohei
authors.initials: K
authors.lastname: Ikezoe
authors.forename: Eizaburo
authors.initials: E
authors.lastname: Sato
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Nakajima
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Taguchi
mesh_terms: D000367:Age Factors; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D016190:Carboplatin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000379:methods; D055752:Small Cell Lung Carcinoma / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D005047:Etoposide; D016190:Carboplatin