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Tuberculosis & Respiratory Diseases

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Vol.65 No.2
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소세포폐암 환자에서 토포테칸 투약 후 발생한 급성호흡곤란증후군

Acute Respiratory Distress Syndrome after Topotecan Therapy in a Patient with Small Cell Lung Cancer

Tuberculosis & Respiratory Diseases / Tuberculosis & Respiratory Diseases,
2008, v.65 no.2, pp.142-146
태정현 (이화의대)
김윤경 (이화여자대학교)
심윤수 (이화의대)
이경종 (이화의대)
노영욱 (이화의대)
박재정 (이화여자대학교)
류연주 (이화여자대학교)
천은미 (이화의대)
장중현 (이화의대)
이진화 (이화여자대학교)
태정현, 김윤경, 심윤수, 이경종, 노영욱, 박재정, 류연주, 천은미, 장중현, & 이진화. (2008). 소세포폐암 환자에서 토포테칸 투약 후 발생한 급성호흡곤란증후군. Tuberculosis & Respiratory Diseases, 65(2), 142-146.
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초록

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 투약 중에 발생한 급성호흡곤란증후군을 경험하여 보고한다. 환자는 호흡곤란을 호소하면서 호흡부전에 빠졌으며, 흉부전산화단층촬영에서 약제에 의한 폐손상을 시사하는 미만성 간유리음영을 보였다. 환자는 급성호흡곤란증후군으로 사망하였다.

keywords
Small cell carcinoma, Topotecan, Acute respiratory distress syndrome

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.

keywords
Small cell carcinoma, Topotecan, Acute respiratory distress syndrome

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Tuberculosis & Respiratory Diseases

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