Different patterns of pneumothorax in patients with soft tissue tumors treated with pazopanib: A case series analysis.

To investigate pneumothorax patterns in pazopanib treatment by focusing on the positional relationship between the visceral pleura and metastatic lung tumor, we examined 20 patients with advanced soft tissue tumors who developed lung metastases and underwent pazopanib treatment between 2012 and 2019...

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Autores principales: Hisaki Aiba, Hiroaki Kimura, Satoshi Yamada, Hideki Okamoto, Katsuhiro Hayashi, Shinji Miwa, Yohei Kawaguchi, Shiro Saito, Takao Sakai, Tsutomu Tatematsu, Ryoichi Nakanishi, Hideki Murakami
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Publicado: Public Library of Science (PLoS) 2021
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spelling oai:doaj.org-article:b6384561afb24d939cdb1e5f08e192cf2021-12-02T20:09:08ZDifferent patterns of pneumothorax in patients with soft tissue tumors treated with pazopanib: A case series analysis.1932-620310.1371/journal.pone.0254866https://doaj.org/article/b6384561afb24d939cdb1e5f08e192cf2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0254866https://doaj.org/toc/1932-6203To investigate pneumothorax patterns in pazopanib treatment by focusing on the positional relationship between the visceral pleura and metastatic lung tumor, we examined 20 patients with advanced soft tissue tumors who developed lung metastases and underwent pazopanib treatment between 2012 and 2019. Pneumothorax was classified into two types based on the location of the metastatic lesion around the visceral pleural area before pazopanib treatment: subpleural type, within 5 mm from the pleura; and central type, >5 mm from the pleura. We investigated the rates of pneumothorax and the associated risk factors. Five patients experienced pneumothorax (three subpleural and two central types). Cavitation preceded pneumothorax in 83% of patients and led to connection of the cavitated cyst of the metastatic lesion to the chest cavity in the shorter term in patients with the subpleural type. Conversely, a more gradual increase in the cavity size and sudden cyst rupture were observed in the central type. The risk factors for pneumothorax were cavitation after initiating pazopanib and intervention before pazopanib, either ablation or surgery. The location of the metastatic lesions was not a risk factor for the occurrence of pneumothorax. In conclusion, pneumothorax is an adverse event associated with pazopanib treatment. Therefore, attention must be paid to predisposing factors such as the formation of cavitation after pazopanib initiation and previous interventions to the lungs. Moreover, because subpleural pneumothorax tends to occur earlier than the central type, a different time course can be anticipated based on the positional relationships of the metastatic lesions to the visceral pleura.Hisaki AibaHiroaki KimuraSatoshi YamadaHideki OkamotoKatsuhiro HayashiShinji MiwaYohei KawaguchiShiro SaitoTakao SakaiTsutomu TatematsuRyoichi NakanishiHideki MurakamiPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0254866 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Hisaki Aiba
Hiroaki Kimura
Satoshi Yamada
Hideki Okamoto
Katsuhiro Hayashi
Shinji Miwa
Yohei Kawaguchi
Shiro Saito
Takao Sakai
Tsutomu Tatematsu
Ryoichi Nakanishi
Hideki Murakami
Different patterns of pneumothorax in patients with soft tissue tumors treated with pazopanib: A case series analysis.
description To investigate pneumothorax patterns in pazopanib treatment by focusing on the positional relationship between the visceral pleura and metastatic lung tumor, we examined 20 patients with advanced soft tissue tumors who developed lung metastases and underwent pazopanib treatment between 2012 and 2019. Pneumothorax was classified into two types based on the location of the metastatic lesion around the visceral pleural area before pazopanib treatment: subpleural type, within 5 mm from the pleura; and central type, >5 mm from the pleura. We investigated the rates of pneumothorax and the associated risk factors. Five patients experienced pneumothorax (three subpleural and two central types). Cavitation preceded pneumothorax in 83% of patients and led to connection of the cavitated cyst of the metastatic lesion to the chest cavity in the shorter term in patients with the subpleural type. Conversely, a more gradual increase in the cavity size and sudden cyst rupture were observed in the central type. The risk factors for pneumothorax were cavitation after initiating pazopanib and intervention before pazopanib, either ablation or surgery. The location of the metastatic lesions was not a risk factor for the occurrence of pneumothorax. In conclusion, pneumothorax is an adverse event associated with pazopanib treatment. Therefore, attention must be paid to predisposing factors such as the formation of cavitation after pazopanib initiation and previous interventions to the lungs. Moreover, because subpleural pneumothorax tends to occur earlier than the central type, a different time course can be anticipated based on the positional relationships of the metastatic lesions to the visceral pleura.
format article
author Hisaki Aiba
Hiroaki Kimura
Satoshi Yamada
Hideki Okamoto
Katsuhiro Hayashi
Shinji Miwa
Yohei Kawaguchi
Shiro Saito
Takao Sakai
Tsutomu Tatematsu
Ryoichi Nakanishi
Hideki Murakami
author_facet Hisaki Aiba
Hiroaki Kimura
Satoshi Yamada
Hideki Okamoto
Katsuhiro Hayashi
Shinji Miwa
Yohei Kawaguchi
Shiro Saito
Takao Sakai
Tsutomu Tatematsu
Ryoichi Nakanishi
Hideki Murakami
author_sort Hisaki Aiba
title Different patterns of pneumothorax in patients with soft tissue tumors treated with pazopanib: A case series analysis.
title_short Different patterns of pneumothorax in patients with soft tissue tumors treated with pazopanib: A case series analysis.
title_full Different patterns of pneumothorax in patients with soft tissue tumors treated with pazopanib: A case series analysis.
title_fullStr Different patterns of pneumothorax in patients with soft tissue tumors treated with pazopanib: A case series analysis.
title_full_unstemmed Different patterns of pneumothorax in patients with soft tissue tumors treated with pazopanib: A case series analysis.
title_sort different patterns of pneumothorax in patients with soft tissue tumors treated with pazopanib: a case series analysis.
publisher Public Library of Science (PLoS)
publishDate 2021
url https://doaj.org/article/b6384561afb24d939cdb1e5f08e192cf
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