[Infectious complications of lung cancer and its management]

Analysis of clinical features of infectious complications of lung cancer was carried out to obtain the informations necessary for the efficient management. Infectious complications developed in 114 patients out of 188 patient of primary lung cancer who were admitted to the institute during the period of two years from 1982 to 1983. From the results of the analysis it was revealed that anticancer chemotherapy was extensively restricted by coexistent infectious complications. Therefore, complete and partial responses in the patients associated with infections was significantly (p less than 0.05) lower than that in the patients without infection. Survival rate at the point of one year after the admission was also lower with significance (p less than 0.05) in the patients with infections than that in the patients without infections. Main and direct cause of the infection was bronchial obstruction. Therefore, the incidence of the infectious complication was the highest in the patients with squamous cell carcinoma. Of defence mechanism against infection, cellular immunity seemed to play the more important role as compared with that of humoral immunity. And it was shown that decrease in number of lymphocytes was most closely related to the development of serious or terminal infections. Causative organisms in most of the pulmonary infections were opportunistic Gram-negative bacilli. Recently, the incidence of the infections due to E. colioand K. pneumoniae decreased and that due to Enterobacteriaceae except for these two species increased. Therapeutic efficacy rate of antimicrobial agents including cephems of the 3rd generation remained as low as 50% or so. However, the cure rate of the triple regimen consisted of beta-lactam, aminoglycoside and tetracycline was revealed to be satisfactorily high.