Tuberc Respir Dis.  2008 Aug;65(2):142-146.

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

• Tae JH
• Lee JH
• Kim YK
• Sim YS
• Lee KJ
• Noh YW
• Park JJ
• Ryu YJ
• Chun EM
• Chang JH

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.

Keyword

Small cell carcinoma; Topotecan; Acute respiratory distress syndrome

MeSH Terms

Carcinoma, Small Cell
DNA Topoisomerases, Type I
Dyspnea
Humans
Respiratory Distress Syndrome, Adult
Respiratory Insufficiency
Small Cell Lung Carcinoma
Thorax
Topotecan
DNA Topoisomerases, Type I
Topotecan

Figure

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  Figure 1 Chest radiograph on admission shows the left upper lobe mass and left pleural effusion (A). Chest radiograph after 3rd topotecan therapy shows diffuse ground-glass opacities in the right lung (B).

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  Figure 2 Chest CT scan prior to topotecan therapy shows lung cancer of left upper lobar bronchus and radiation pneumonitis (A). Chest CT on the 7th hospital day scan shows newly appeared diffuse ground-glass opacities in the right lung (B).

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  Figure 3 Chest radiograph on the 12th hospital day shows aggravated diffuse ground-glass opacities in both lungs.

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