Toxicity and efficacy of chemotherapy for non-small cell lung cancer with cavitary lesions.
BACKGROUND
Concurrent chemoradiation in stage III non-small cell lung cancer (NSCLC) patients with cavitary lesions is reported to cause serious lung complications and is a predictor of poor survival. However, the efficacy and toxicity associated with chemotherapy for advanced NSCLC patients with cavitary lesions is not clear. We investigated the toxicities, particularly hemoptysis and cavity infection, and efficacy associated with chemotherapy for NSCLC patients with cavitary lesions.


METHODS
We retrospectively reviewed consecutive patients who received first-line chemotherapy, including platinum-based chemotherapy, single-agent chemotherapy, or epidermal growth factor receptor-tyrosine kinase inhibitors, at our institution between January 2008 and December 2010.


RESULTS
We found tumor cavitation prior to treatment in 23 of 415 NSCLC patients (5.5%). The response rate of all the patients was 30%, and the median survival time (MST) was 8.9 months. The MST of the 15 patients treated with platinum-based chemotherapy was 11 months. Grade 1 bronchopulmonary hemorrhage occurred in 2 patients. Grade 3 cavitary infection occurred in 2 patients, resulting in the discontinuation of chemotherapy.


CONCLUSIONS
This study indicates that the toxicity of chemotherapy for NSCLC patients with cavitary lesions is tolerable; however, the development of cavitary infection should be carefully considered. In addition, this study suggests that the efficacy of chemotherapy for NSCLC patients with cavitary lesions is similar to the response rates reported in the literature; however, the survival of these patients may be worse than that for general NSCLC patients.
Division of Thoracic Oncology, Shizuoka Cancer Center, Nagaizumi-cho, Sunto-gun, Japan. Electronic address: t.tokito@scchr.jp.
Takaaki
T
Tokito
Division of Thoracic Oncology, Shizuoka Cancer Center, Nagaizumi-cho, Sunto-gun, Japan; Department of Respiratory Medicine, Juntendo University, Hongou Bunkyou-ku, Tokyo, Japan. Electronic address: tshukuya@juntendo.ac.jp.
Takehito
T
Shukuya
Division of Thoracic Oncology, Shizuoka Cancer Center, Nagaizumi-cho, Sunto-gun, Japan. Electronic address: h.akamatsu@scchr.jp.
Hiroaki
H
Akamatsu
Division of Thoracic Oncology, Shizuoka Cancer Center, Nagaizumi-cho, Sunto-gun, Japan. Electronic address: a.ono@scchr.jp.
Akira
A
Ono
Division of Thoracic Oncology, Shizuoka Cancer Center, Nagaizumi-cho, Sunto-gun, Japan. Electronic address: t.taira@scchr.jp.
Tetsuhiko
T
Taira
Division of Thoracic Oncology, Shizuoka Cancer Center, Nagaizumi-cho, Sunto-gun, Japan. Electronic address: h.kenmotsu@scchr.jp.
Hirotsugu
H
Kenmotsu
Division of Thoracic Oncology, Shizuoka Cancer Center, Nagaizumi-cho, Sunto-gun, Japan. Electronic address: t.naito@scchr.jp.
Tateaki
T
Naito
Division of Thoracic Oncology, Shizuoka Cancer Center, Nagaizumi-cho, Sunto-gun, Japan. Electronic address: ha.murakami@scchr.jp.
Haruyasu
H
Murakami
Division of Thoracic Oncology, Shizuoka Cancer Center, Nagaizumi-cho, Sunto-gun, Japan. Electronic address: t.takahashi@scchr.jp.
Toshiaki
T
Takahashi
Division of Diagnostic Radiology, Shizuoka Cancer Center, Nagaizumi-cho, Sunto-gun, Japan. Electronic address: m.endo@scchr.jp.
Masahiro
M
Endo
Division of Clinical Trial Center, Shizuoka Cancer Center, Nagaizumi-cho, Sunto-gun, Japan. Electronic address: ke.mori@scchr.jp.
Keita
K
Mori
Division of Thoracic Oncology, Shizuoka Cancer Center, Nagaizumi-cho, Sunto-gun, Japan; Third Department of Internal Medicine, Wakayama Medical University, Kimiidera, Wakayama, Japan. Electronic address: nbyamamo@wakayama-med.ac.jp.
Nobuyuki
N
Yamamoto
D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
D047428:Protein Kinase Inhibitors; D066246:ErbB Receptors; D002945:Cisplatin
Bronchopulmonary hemorrhage; Cavitary infection; Cavity; Chemotherapy; Non-small cell carcinoma