Ewha Med J.  2014 Dec;37(Suppl):S5-S9. 10.12771/emj.2014.37.S.S5.

Chemotherapy in Small Cell Lung Cancer with End-Stage Renal Disease on Hemodialysis

• Choi SI
• Park SS
• Ko EJ
• Lee SW
• Choi M
• Kim K

• KMID: 2171303
• DOI: http://doi.org/10.12771/emj.2014.37.S.S5

Abstract

Small cell lung cancer is primarily treated with chemotherapy. For patients with end-stage renal disease (ESRD), systemic chemotherapy is often challenging since renal excretion of chemotherapeutic agents might be decreased due to impaired renal function, leading to increased toxicity. No consensus is made so far regarding appropriate dosage and combination of chemotherapeutic agents for patients on hemodialysis. We report two cases of chemotherapy without significant toxicity in small cell lung cancer patients who were on hemodialysis for ESRD.

Keyword

Small cell lung carcinoma; Drug therapy; Kidney failure, chronic; Renal dialysis

MeSH Terms

Consensus
Drug Therapy*
Humans
Kidney Failure, Chronic*
Renal Dialysis*
Small Cell Lung Carcinoma*

Figure

• 

  Fig. 1 Positron emission tomography at the time of initial diagnosis (A), after 3 cycles of treatment (B), after 6 cycles of treatment (C), and 6 weaks after the treatment completion (D).

• 

  Fig. 2 Treatment course from the time of diagnosis of case 2. PR, partial response; PD, progression of disease.

Reference

1. Na SY, Sung JY, Chang JH, Kim S, Lee HH, Park YH, et al. Chronic kidney disease in cancer patients: an independent predictor of cancer-specific mortality. Am J Nephrol. 2011; 33:121–130.

2. Oguri T, Shimokata T, Inada M, Ito I, Ando Y, Sasaki Y, et al. Pharmacokinetic analysis of carboplatin in patients with cancer who are undergoing hemodialysis. Cancer Chemother Pharmacol. 2010; 66:813–817.

3. Kim DM, Kim HL, Chung CH, Park CY. Successful treatment of small-cell lung cancer with irinotecan in a hemodialysis patient with end-stage renal disease. Korean J Intern Med. 2009; 24:73–75.

4. Takezawa K, Okamoto I, Fukuoka M, Nakagawa K. Pharmacokinetic analysis of carboplatin and etoposide in a small cell lung cancer patient undergoing hemodialysis. J Thorac Oncol. 2008; 3:1073–1075.

5. Tanizawa K, Fukunaga K, Okumura N, Sugimura M, Tanaka E, Hajiro T, et al. Successful chemotherapy for small-cell lung cancer in an elderly patient undergoing continuous ambulatory peritoneal dialysis. Intern Med. 2010; 49:1179–1183.

6. Hiraike M, Hiraki Y, Misumi N, Hanada K, Tsuji Y, Kamimura H, et al. Pharmacokinetics of carboplatin in a hemodialysis patient with small-cell lung cancer. Cancer Chemother Pharmacol. 2012; 69:845–848.

7. Murakami K, Akutsu Y, Miyazawa Y, Shuto K, Shiratori T, Uesato M, et al. A case of small-cell esophageal cancer with chronic renal failure undergoing hemodialysis safely treated with cisplatin and etoposide. Esophagus. 2011; 8:209–215.

8. Calvert AH, Newell DR, Gumbrell LA, O'Reilly S, Burnell M, Boxall FE, et al. Carboplatin dosage: prospective evaluation of a simple formula based on renal function. J Clin Oncol. 1989; 7:1748–1756.

9. Janus N, Thariat J, Boulanger H, Deray G, Launay-Vacher V. Proposal for dosage adjustment and timing of chemotherapy in hemodialyzed patients. Ann Oncol. 2010; 21:1395–1403.

10. Schmittel A, Sebastian M, Fischer von, Martus P, Gauler TC, Kaufmann C, et al. A German multicenter, randomized phase III trial comparing irinotecan-carboplatin with etoposide-carboplatin as first-line therapy for extensive-disease small-cell lung cancer. Ann Oncol. 2011; 22:1798–1804.