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KMID : 0880520100460010019
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Chonnam Medical Journal
2010 Volume.46 No. 1 p.19 ~ p.24
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Risk Factors for Fatal Hemoptysis after Concurrent Chemoradiation Therapy in Patients with Non-Small Cell Lung Carcinoma
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Kim Yoon-Hee
Kim Eun-Young
Ban Hee-Jung
Oh In-Jae
Kim Kyu-Sik
Kim Young-Chul
Ahn Sung-Ja
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Abstract
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Massive hemoptysis is a serious complication leading to death in lung cancer patients. To investigate whether fatal hemoptysis is associated with concurrent chemoradiation therapy (CCRT), the authors retrospectively analyzed risk factors for fatal hemoptysis after CCRT. The records of 150 patients (129 men and 21 women) with non-small cell lung cancer (NSCLC) who were treated with CCRT from April 2004 to June 2007 were reviewed for toxicity-related fatal hemoptysis. The dose of radiation ranged from 2500 to 9660 cGy, with a mean dose of 6506 cGy. Paclitaxel (45 mg/m2), docetaxel (20 mg/m2), or gemcitabine (350 mg/m2) with cisplatin 20 mg/m2 given weekly for 6 weeks during radiation therapy. Out of 150 patients, 12 (8.0%) patients died of fatal hemoptysis, and all but three had central and squamous tumors. Most of them had radiation pneumonitis or fibrosis. Median time to fatal hemoptysis after CCRT was 9.6 months, ranging from 84 days to 22 months. From a univariate analysis, the significant clinical factors for fatal hemoptysis were central location (p=0.004), central & squamous tumor (p=0.004), poor performance status (p=0.018), and chemotherapy with gemcitabine (p=0.017). From a multivariate analysis, poor performance status (OR=6.698, 95% CI, 1.083~41.430, p=0.041) and central location (OR=6.976, 95% CI, 1.414~34.430, p=0.017) were independent risk factors. Centrally located tumors and poor performance status have been found to be significantly associated with fatal hemoptysis in NSCLC patients treated with CCRT.
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KEYWORD
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Hemoptysis, Lung neoplasms, Drug therapy, Radiotherapy
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