Chemotherapy-Associated Pulmonary Toxicity—Case Series from a Single Center

Background Pulmonary toxicity due to chemotherapeutic agents can occur with many established and new drugs. Strong clinical suspicion is important as the clinical presentation is usually with nonspecific symptoms like cough, dyspnea, fever, and pulmonary infiltrates. Timely discontinuation of the of...

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Autores principales:	Tilak TVSVGK, Ajay Handa, Kishore Kumar, Deepti Mutreja, Shankar Subramanian
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Medical and Scientific Publishers Pvt. Ltd. 2021
Materias:	chemotherapy-associated pulmonary toxicity ground-glass opacities transbronchial lung biopsy organizing pneumonia Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/8574c32042e0473bb262ae55ff7d76eb
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spelling	oai:doaj.org-article:8574c32042e0473bb262ae55ff7d76eb2021-11-12T00:02:41ZChemotherapy-Associated Pulmonary Toxicity—Case Series from a Single Center2278-330X2278-430610.1055/s-0041-1731581https://doaj.org/article/8574c32042e0473bb262ae55ff7d76eb2021-11-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1731581https://doaj.org/toc/2278-330Xhttps://doaj.org/toc/2278-4306Background Pulmonary toxicity due to chemotherapeutic agents can occur with many established and new drugs. Strong clinical suspicion is important as the clinical presentation is usually with nonspecific symptoms like cough, dyspnea, fever, and pulmonary infiltrates. Timely discontinuation of the offending agent alone can improve the condition. Methods A prospective observational study on patients receiving chemotherapy at an 800-bedded tertiary care hospital was performed from 2014 to 2016. Consecutive patients on chemotherapy, presenting with nonresolving respiratory symptoms were evaluated with contrast-enhanced computerized tomography of chest, diffusion lung capacity for carbon monoxide (DLCO), fiberoptic bronchoscopy with lavage, and biopsy, after excluding all causes for pulmonary infections. Descriptive data has been depicted. Results A total of 18 patients were evaluated for persistent symptoms of dry cough, dyspnea, and fever among 624 who received chemotherapy during the study period. Ground-glass opacities on high-resolution CT was the most common imaging finding, others being patchy subpleural consolidation and pleural effusion. Lymphocyte-predominant bronchoalveolar lavage was detected in nine. Eight of the 15 patients who underwent DLCO, had abnormal results. Seven had significant histopathological findings on bronchoscopic lung biopsy, which revealed organizing pneumonia as the most common pattern. Paclitaxel, fluorouracil, gemcitabine, and tyrosine kinase inhibitors were the common culprit drugs. Discontinuation alone of the culprit drug was effective in 15 and 3 needed oral corticosteroids for relief of symptoms. None of the patients died due to the toxicity. Conclusion An incidence of 2.8% for chemotherapy-induced lung injury was seen in our observational study of 3 years, with parenchymal, interstitial, and pleural involvement due to various chemotherapeutic agents. Oral steroids maybe required in a subset of patients not responding to discontinuation of the culprit agent.Tilak TVSVGKAjay HandaKishore KumarDeepti MutrejaShankar SubramanianThieme Medical and Scientific Publishers Pvt. Ltd.articlechemotherapy-associated pulmonary toxicityground-glass opacitiestransbronchial lung biopsyorganizing pneumoniaNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENSouth Asian Journal of Cancer (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	chemotherapy-associated pulmonary toxicity ground-glass opacities transbronchial lung biopsy organizing pneumonia Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	chemotherapy-associated pulmonary toxicity ground-glass opacities transbronchial lung biopsy organizing pneumonia Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Tilak TVSVGK Ajay Handa Kishore Kumar Deepti Mutreja Shankar Subramanian Chemotherapy-Associated Pulmonary Toxicity—Case Series from a Single Center
description	Background Pulmonary toxicity due to chemotherapeutic agents can occur with many established and new drugs. Strong clinical suspicion is important as the clinical presentation is usually with nonspecific symptoms like cough, dyspnea, fever, and pulmonary infiltrates. Timely discontinuation of the offending agent alone can improve the condition. Methods A prospective observational study on patients receiving chemotherapy at an 800-bedded tertiary care hospital was performed from 2014 to 2016. Consecutive patients on chemotherapy, presenting with nonresolving respiratory symptoms were evaluated with contrast-enhanced computerized tomography of chest, diffusion lung capacity for carbon monoxide (DLCO), fiberoptic bronchoscopy with lavage, and biopsy, after excluding all causes for pulmonary infections. Descriptive data has been depicted. Results A total of 18 patients were evaluated for persistent symptoms of dry cough, dyspnea, and fever among 624 who received chemotherapy during the study period. Ground-glass opacities on high-resolution CT was the most common imaging finding, others being patchy subpleural consolidation and pleural effusion. Lymphocyte-predominant bronchoalveolar lavage was detected in nine. Eight of the 15 patients who underwent DLCO, had abnormal results. Seven had significant histopathological findings on bronchoscopic lung biopsy, which revealed organizing pneumonia as the most common pattern. Paclitaxel, fluorouracil, gemcitabine, and tyrosine kinase inhibitors were the common culprit drugs. Discontinuation alone of the culprit drug was effective in 15 and 3 needed oral corticosteroids for relief of symptoms. None of the patients died due to the toxicity. Conclusion An incidence of 2.8% for chemotherapy-induced lung injury was seen in our observational study of 3 years, with parenchymal, interstitial, and pleural involvement due to various chemotherapeutic agents. Oral steroids maybe required in a subset of patients not responding to discontinuation of the culprit agent.
format	article
author	Tilak TVSVGK Ajay Handa Kishore Kumar Deepti Mutreja Shankar Subramanian
author_facet	Tilak TVSVGK Ajay Handa Kishore Kumar Deepti Mutreja Shankar Subramanian
author_sort	Tilak TVSVGK
title	Chemotherapy-Associated Pulmonary Toxicity—Case Series from a Single Center
title_short	Chemotherapy-Associated Pulmonary Toxicity—Case Series from a Single Center
title_full	Chemotherapy-Associated Pulmonary Toxicity—Case Series from a Single Center
title_fullStr	Chemotherapy-Associated Pulmonary Toxicity—Case Series from a Single Center
title_full_unstemmed	Chemotherapy-Associated Pulmonary Toxicity—Case Series from a Single Center
title_sort	chemotherapy-associated pulmonary toxicity—case series from a single center
publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
publishDate	2021
url	https://doaj.org/article/8574c32042e0473bb262ae55ff7d76eb
work_keys_str_mv	AT tilaktvsvgk chemotherapyassociatedpulmonarytoxicitycaseseriesfromasinglecenter AT ajayhanda chemotherapyassociatedpulmonarytoxicitycaseseriesfromasinglecenter AT kishorekumar chemotherapyassociatedpulmonarytoxicitycaseseriesfromasinglecenter AT deeptimutreja chemotherapyassociatedpulmonarytoxicitycaseseriesfromasinglecenter AT shankarsubramanian chemotherapyassociatedpulmonarytoxicitycaseseriesfromasinglecenter
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Chemotherapy-Associated Pulmonary Toxicity—Case Series from a Single Center

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