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The effect of pulmonary function testing on bleomycin dosing in germ cell tumours
Author(s) -
Roncolato F. T.,
Chatfield M.,
Houghton B.,
Toner G.,
Stockler M.,
Thomson D.,
Friedlander M.,
Gurney H.,
Rosenthal M.,
Grimison, P.
Publication year - 2016
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.13158
Subject(s) - medicine , dlco , bleomycin , pulmonary function testing , pulmonary toxicity , asymptomatic , lung volumes , dosing , vital capacity , germ cell tumors , lung , surgery , diffusing capacity , chemotherapy , lung function
Background/Aim The utility of pulmonary function testing ( PFT ) to detect bleomycin‐induced pneumonitis is controversial. We describe its impact on bleomycin dosing in a phase 2 trial of accelerated BEP (bleomycin, etoposide, cisplatin) for advanced germ cell tumours. Methods There were 12 planned weekly bleomycin doses for intermediate‐risk and poor‐risk disease and nine for good‐risk disease. Clinical assessments, chest X‐ray, diffusing capacity of lung for carbon monoxide ( DLCO ) and forced vital capacity (FVC) were performed bi‐weekly. Bleomycin was ceased for predefined clinical/radiological evidence of pulmonary toxicity and a >25% reduction in DLCO or FVC . We determined doses planned, received and omitted and patients receiving all, ≥two‐thirds, two‐thirds of planned bleomycin doses. Results Of 43 eligible patients, 30% had lung metastases. Of 471, 375 (80%) of planned bleomycin doses were received, and 30% received 25% reduction in DLCO (35 vs 24%, P = 0.4) and 1.5 times as likely to receive