Long-term survival in a patient with small-cell lung cancer undergoing hemodialysis who received multiple courses of chemotherapy.
The prognosis of small-cell lung cancer remains poor and it is speculated that small-cell lung cancer patients with end-stage renal failure undergoing hemodialysis have a poorer prognosis. In this article, we present a Japanese woman with extensive small-cell lung cancer with end-stage renal failure undergoing hemodialysis who received multiple courses of chemotherapy. Although she achieved long-term survival of more than 2 years, the last-line chemotherapy, consisting of irinotecan, induced grade 4 febrile neutropenia and her performance status deteriorated even with a reduced dose according to the analysis of UDP-glucuronosyltransferase 1A1. We also conducted a pharmacokinetic analysis of irinotecan, the resulting values of which were much higher than in previous reports. Although further studies are needed, chemotherapy for small-cell lung cancer patients should not be withheld just because they are undergoing hemodialysis; however, chemotherapy should be performed more carefully because more severe toxicities can occur than expected.
Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaracho, Sakyo-ku, Kyoto 606-8507, Japan.
Yosuke
Y
Togashi
Young Hak
YH
Kim
Katsuhiro
K
Masago
Yuichi
Y
Sakamori
Chiyuki
C
Okuda
Tadashi
T
Mio
Michiaki
M
Mishima
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D044466:Asian People; D002166:Camptothecin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives / Q000493:pharmacokinetics; D018288:Carcinoma, Small Cell / Q000188:drug therapy*; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D000077146:Irinotecan; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008175:Lung Neoplasms / Q000188:drug therapy*; D009503:Neutropenia / Q000139:chemically induced* / Q000150:complications; D006435:Renal Dialysis; D016896:Treatment Outcome
D000077146:Irinotecan; D002166:Camptothecin