Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Acute Respiratory Distress Syndrome after Topotecan Therapy in a Patient with Small Cell Lung Cancer

소세포폐암 환자에서 토포테칸 투약 후 발생한 급성호흡곤란증후군

  • Tae, Jung Hyun (Department of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Lee, Jin Hwa (Department of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Kim, Yoon Kyung (Department of Radiology, Ewha Womans University School of Medicine) ;
  • Sim, Yun Su (Department of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Lee, Kyung Jong (Department of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Noh, Young Wook (Department of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Park, Jae Jung (Department of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Ryu, Yon Ju (Department of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Chun, Eun Mi (Department of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Chang, Jung Hyun (Department of Internal Medicine, Ewha Womans University School of Medicine)
  • 태정현 (이화여자대학교 의학전문대학원 내과학교실) ;
  • 이진화 (이화여자대학교 의학전문대학원 내과학교실) ;
  • 김윤경 (이화여자대학교 의학전문대학원 영상의학교실) ;
  • 심윤수 (이화여자대학교 의학전문대학원 내과학교실) ;
  • 이경종 (이화여자대학교 의학전문대학원 내과학교실) ;
  • 노영욱 (이화여자대학교 의학전문대학원 내과학교실) ;
  • 박재정 (이화여자대학교 의학전문대학원 내과학교실) ;
  • 류연주 (이화여자대학교 의학전문대학원 내과학교실) ;
  • 천은미 (이화여자대학교 의학전문대학원 내과학교실) ;
  • 장중현 (이화여자대학교 의학전문대학원 내과학교실)
  • Received : 2008.05.27
  • Accepted : 2008.07.08
  • Published : 2008.08.30
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Abstract

Small cell lung cancer is characterized by an aggressive clinical course and a high tendency for early dissemination in spite of a good chemotherapy response. Topotecan is a topoisomerase I inhibitor, and it is used as second-line treatment for small cell lung cancer. The reported dose-limiting adverse reactions to topotecan are mainly hematologic. Yet pulmonary toxicity associated with topotecan is known to be rare. We report here on a case that showed the development of acute respiratory distress syndrome during the 3rd cycle of topotecan chemotherapy in a patient with small cell lung cancer. He developed dyspnea and respiratory failure, and the chest CT scan revealed diffuse ground-glass opacity that was probably due to chemotherapy-related pulmonary toxicity. He finally died of acute respiratory distress syndrome.

소세포폐암은 비교적 초기 항암치료에 대한 반응이 우수하지만 빠르게 진행하는 것으로 알려져 있다. Topotecan은 topoisomerase I inhibitor로 소세포폐암에서 이차치료제로 사용된다. Topotecan의 흔한 부작용으로는 빈혈, 혈소판감소증, 호중구감소증과 같은 혈액학적 부작용이 있으나, topotecan에 의한 폐독성은 잘 알려져 있지 않다. 저자들은 일차치료에 불응하여 이차치료제로 topotecan을 투여 받던 소세포폐암 환자에서 3주기 topotecan 투약중에 발생한 급성호흡곤란증후군을 경험하여 보고한다. 환자는 호흡곤란을 호소하면서 호흡부전에 빠졌으며, 흉부전산화단층촬영에서 약제에 의한 폐손상을 시사하는 미만성 간유리음영을 보였다. 환자는 급성호흡곤란증후군으로 사망하였다.

Keywords

References

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