A Case of Pneumocystis Carinii Pneumonia with Diffuse Pulmonary Hemorrhage

Background : Paclitaxel is highly beneficial anticancer drug for the treatment of non-small cell lung cancer and has shown remarkable radiosensitizing effect in vitro. We evaluated whether concurrent chemoradiation therapy with weekly paclitaxel (60 mg/m2) could be tolerated and effective in the treatment of locally advanced non-small cell lung cancer (NSCLC). Methods : Twenty-two stage III (IIIA:6, IIIB:16) NSCLC patients were treated with weekly administration of paclitaxel (60 mg/m2) on days 1, 8, 15, 22, 29, and 36 in addition to concurrent radiation therapy of 54 Gy. After the initial phase of concurrent chemoradiation, patients received additional two cycles of consolidation chemotherapy with paclitaxel (175mg/m2)/cisplatin (75 mg/m2) or paclitaxel (175 mg/m2)/carboplatin (6AUC) every 3 weeks. Results : Overall response rate was 81.8% (18/22) with 9.1% (2/22) of complete response and 72.7% (16/22) of partial response rate. Two patients (9.1%) died of chemoradiation-induced pneumonitis after completion of therapy. In total, grade 3 toxicities included pneumonitis (22.7%), esophagitis (22.7%), neuropathy (13.6%), and neutropenia (13.6%). The median survival time was 15 months and 2-year overall survival were 31.8%. Conclusion : Concurrent chemoradiation therapy with weekly paclitaxel in locally advanced NSCLC showed good local response, but survival rate was not completely satisfactory due to potentially fatal chemoradiation-induced pneumonitis.(Tuberc Respir Dis 2004; 57:351-357)

keywords: Pneumocystis carinii pneumonia, Diffuse pulmonary hemorrhage.론, Pneumocystis carinii pneumonia, Diffuse pulmonary hemorrhage.론

Reference

(1997) Alveolar damage in AIDS-related pneumocystis carinii pneumonia,

(1999) Pneumocystis carinii pneumonia in human immunodeficiency virus (HIV)- positive and HIV neqative immunocompromised patients,

(1999) Determinants of short- and longterm outcome in patients with respiratory failure caused by AIDS-related pneumocystis carinii pneumonia,

(clininfectdis1999) The risk of pneumocystis carinii pneumonia among men infected with human immunodeficiency virus type 1 Pneumocystis carinii pneumonia in human immunodeficiency virus, multicenter AIDS cohort study group

(1999) Radiographic and HRCT Findings of Pneumocystis Carinii Pneumonia,

(1996) Pulmonary capillaritis and alveolar hemorrhage,

(2001) AIDS-related alveolar hemorrhage,

(1994) Bronchoaveolar Lavage of Pneumocystis carinii Pneumonia,

(1989) Pulmonary cysts associated with pneumocystis carinii pneumonia in patients with AIDS,

10.

(1987) Roentgenographic patterns of pneumocystis carinii pneumonia in 104 patients with AIDS,

11.

(1996) Pneumocystis carinii Pneumonia Presented as Diffuse Alveolar Damage,

12.

(2002) Twenty cases of diffuse alveolar hemorrhage:A single center retrospective study,

13.

(2001) Diffuse alveolar hemorrhage syndromes,

14.

(1998) Radiologic Findings of Diffuse Pulmonary Hemorrhage,

15.

(2000) Alveolar hemorrhage in systemic lupus erythematosus,

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Article Contents

Vol.57 No.4

A Case of Pneumocystis Carinii Pneumonia with Diffuse Pulmonary Hemorrhage

Abstract

Reference

Tuberculosis & Respiratory Diseases