Takaaki Tokito1, Takehito Shukuya2, Hiroaki Akamatsu3, Akira Ono4, Tetsuhiko Taira5, Hirotsugu Kenmotsu6, Tateaki Naito7, Haruyasu Murakami8, Toshiaki Takahashi9, Masahiro Endo10, Keita Mori11, Nobuyuki Yamamoto12. 1. Division of Thoracic Oncology, Shizuoka Cancer Center, Nagaizumi-cho, Sunto-gun, Japan. Electronic address: t.tokito@scchr.jp. 2. 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. 3. Division of Thoracic Oncology, Shizuoka Cancer Center, Nagaizumi-cho, Sunto-gun, Japan. Electronic address: h.akamatsu@scchr.jp. 4. Division of Thoracic Oncology, Shizuoka Cancer Center, Nagaizumi-cho, Sunto-gun, Japan. Electronic address: a.ono@scchr.jp. 5. Division of Thoracic Oncology, Shizuoka Cancer Center, Nagaizumi-cho, Sunto-gun, Japan. Electronic address: t.taira@scchr.jp. 6. Division of Thoracic Oncology, Shizuoka Cancer Center, Nagaizumi-cho, Sunto-gun, Japan. Electronic address: h.kenmotsu@scchr.jp. 7. Division of Thoracic Oncology, Shizuoka Cancer Center, Nagaizumi-cho, Sunto-gun, Japan. Electronic address: t.naito@scchr.jp. 8. Division of Thoracic Oncology, Shizuoka Cancer Center, Nagaizumi-cho, Sunto-gun, Japan. Electronic address: ha.murakami@scchr.jp. 9. Division of Thoracic Oncology, Shizuoka Cancer Center, Nagaizumi-cho, Sunto-gun, Japan. Electronic address: t.takahashi@scchr.jp. 10. Division of Diagnostic Radiology, Shizuoka Cancer Center, Nagaizumi-cho, Sunto-gun, Japan. Electronic address: m.endo@scchr.jp. 11. Division of Clinical Trial Center, Shizuoka Cancer Center, Nagaizumi-cho, Sunto-gun, Japan. Electronic address: ke.mori@scchr.jp. 12. 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.
Abstract
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.
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 NSCLCpatients with cavitary lesions is not clear. We investigated the toxicities, particularly hemoptysis and cavity infection, and efficacy associated with chemotherapy for NSCLCpatients 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 NSCLCpatients (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 NSCLCpatients 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 NSCLCpatients 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 NSCLCpatients.