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Vol.48 No.4 contents | Japanese/English |
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- Case Report -
A Dialysis Patient with Pulmonary Adenocarcinoma Responded to the Weekly Carboplatin+Paclitaxel Combination
Toshiyuki Hirose1, Yasushi Nakagawa11Department of Respiratory Surgery, National Hospital Organization Higashitokushima Hospital, Japan
Background. Although the number of lung cancer patients on hemodialysis is expected to increase in the future, no treatment regimen has been established yet. Case. A 75-year-old man had been under dialysis for chronic renal failure since the age of 65. An abnormal shadow was detected near the right hilum in a regular medical check-up in April 2005. An infiltrating shadow associated with an air bronchogram was noted in the right upper lobe on chest CT. Among various tumor markers, CYFRA showed an increase to 87 ng/ml. A diagnosis of adenocarcinoma was made based on the findings of cytology by bronchoscopy. Since intrapulmonary metastasis was noted in the right middle lower lobe, a diagnosis of T2N1M1 stage IV was made and we decided to give chemotherapy. Carboplatin (CBDCA) [Area under the curve (AUC) 2.0] and Paclitaxel (PTX) (70 mg/m2) were administered on days 1, 8, and 15 every 28 days. Dialysis was conducted for 4 hours starting 2 hours after completion of administration of CBDCA. Adverse reactions observed included Grade 2 anorexia, nausea and hair loss and Grade 3 neutropenia, anemia, and febrile neutropenia. The dose of CBDCA and PTX was reduced to AUC 1.68 and 65 mg/m2, respectively, in subsequent cycles. Symptoms and shadows showed improvements and CYFRA decreased to the normal level. A pharmacokinetic study during the third course showed that the AUCs of CBDCA and PTX were 1.16 μg-min/ml and 3.49 μg-h/ml, respectively. The patient was observed after completing 4 cycles. However, shadows worsened again and he passed away in September 2006. Conclusion. This paper described a dialysis patient with pulmonary adenocarcinoma who responded to the weekly CBDCA+PTX combination. This regimen in a dialysis patient can be safely conducted as an outpatient basis.
key words: Hemodialysis, Pulmonary adenocarcinoma, Carboplatin, Paclitaxel
Received: January 9, 2008
Accepted: May 30, 2008
JJLC 48 (4): 285-289, 2008
