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[Nitrosourea-induced lung diseases].

F Massin1, B Coudert, P Foucher

  • 1Service de Pneumologie et de Réanimation Respiratoire, CHU, Dijon.

Revue Des Maladies Respiratoires
|January 1, 1992
PubMed
Summary

Nitrosourea chemotherapy, particularly BCNU, can cause severe lung damage (pulmonary toxicity) in brain cancer patients. Higher cumulative doses increase the risk of developing this irreversible fibrosis and hypoxemia.

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Area of Science:

  • Oncology
  • Pulmonology
  • Pharmacology

Background:

  • Nitrosoureas are alkylating agents used for brain malignancies due to their ability to cross the blood-brain barrier.
  • Pulmonary toxicity associated with nitrosoureas, especially BCNU, has been a recognized complication since 1976.
  • The exact prevalence of nitrosourea-induced lung disease is uncertain, with estimates ranging from 1% to 20%.

Purpose of the Study:

  • To review the literature on nitrosourea-induced pulmonary toxicity.
  • To characterize the clinical presentation, histopathology, and outcomes of this adverse effect.
  • To discuss potential management strategies.

Main Methods:

  • Literature review of 72 reported cases of nitrosourea-induced pulmonary toxicity.
  • Analysis of clinical features, histopathological findings (55 reports), and patient outcomes.

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  • Assessment of the relationship between cumulative nitrosourea exposure and toxicity risk.

    • Main Results:

    • A direct correlation exists between cumulative nitrosourea exposure and the risk of pulmonary toxicity.
    • The condition manifests as diffuse, severe pulmonary fibrosis with hypoxemia.
    • Histopathology reveals diffuse bland fibrosis.
    • Patient outcomes are poor, with a 67% mortality rate reported.

    Conclusions:

    • Nitrosourea-induced lung disease is a serious complication of brain cancer treatment.
    • Corticosteroids may offer limited benefit in managing this toxicity.
    • Further research into effective treatments is warranted.