title: [CPT-11 chemotherapy for a hemodialysis patient with small-cell lung cancer].
abstract: We report a hemodialysis patient with extensive small-cell lung cancer who was administered CPT-11(50mg/m2)chemotherapy and achieved a partial response after four courses of chemotherapy. Hemodialysis was performed 24 hours after the first course of CPT-11 was completed. Because the patient developed thrombocytopenia and pneumonia, hemodialysis was performed 4 hours following the second course of chemotherapy, after which grade III bone marrow suppression was observed. The plasma concentrations of CPT-11 and its metabolic products(SN-38 and SN-38G)were measured during both courses. A pharmacokinetic study showed that the plasma concentration of CPT-11 after the first course was relatively high, and that the kinetics was similar to that in a non-dialysis case. However, 4 hours after hemodialysis, the concentrations of CPT-11 and SN-38G were re-elevated, and showed a sustained level higher than that obtained 24 hours after hemodialysis. Further study is needed to determine the optimal dosages of CPT-11, and the best time to conduct hemodialysis for chronic cancer patients requiring it.
authors.affiliation: Respiratory Disease Center, Showa University Northern Yokohama Hospital.
authors.forename: Ryozou
authors.initials: R
authors.lastname: Gen
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Shikama
authors.forename: Shigeru
authors.initials: S
authors.lastname: Tanzawa
authors.forename: Nanae
authors.initials: N
authors.lastname: Inoue
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shibuya
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nakajima
mesh_terms: D000368:Aged; D000972:Antineoplastic Agents, Phytogenic / Q000097:blood / Q000627:therapeutic use*; D002166:Camptothecin / Q000031:analogs & derivatives* / Q000097:blood / Q000627:therapeutic use; D017321:Clinical Trials, Phase I as Topic; D006801:Humans; D000077146:Irinotecan; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000628:therapy; D008175:Lung Neoplasms / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D008297:Male; D006435:Renal Dialysis / Q000379:methods*; D055752:Small Cell Lung Carcinoma / Q000097:blood / Q000150:complications / Q000188:drug therapy*
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D000077146:Irinotecan; D002166:Camptothecin