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Radiation‐induced lung fibrosis after treatment of small cell carcinoma of the lung with very high‐dose cyclophosphamide
Author(s) -
Trask Colin W. L.,
Joannides Theo,
Harper Peter G.,
Tobias Jeffry S.,
Spiro Stephen G.,
Geddes Duncan M.,
Souhami Robert L.,
Beverly Peter C. L.
Publication year - 1985
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19850101)55:1<57::aid-cncr2820550110>3.0.co;2-l
Subject(s) - medicine , cyclophosphamide , radiation therapy , lung , fibrosis , mediastinum , chemotherapy , pulmonary fibrosis , regimen , carcinoma , surgery , oncology
Twenty‐five previously untreated patients with small cell carcinoma of the lung were treated with cyclophosphamide 160 to 200 mg/kg (with autologous bone marrow support) followed by radiotherapy (4000 cGy) to the primary site and mediastinum. No other treatment was given until relapse occurred. Nineteen patients were assessable at least 4 months after radiotherapy; of these, 15 (79%) developed radiologic evidence of fibrosis, which was symptomatic in 14 (74%). The time of onset of fibrosis was related to the volume of lung irradiated. A retrospective analysis was made of 20 consecutive patients treated with multiple‐drug chemotherapy and an identical radiotherapy regimen as part of a randomized trial. Radiologic and symptomatic fibrosis was one half as frequent (35%) as in the high‐dose cyclophosphamide group. Very high‐dose cyclophosphamide appears to sensitize the lung to radiotherapy and promotes the production of fibrosis.