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Decrease in pulmonary function during bleomycin-containing combination chemotherapy for testicular cancer: not only a

S Sleijfer1, T W van der Mark, H Schraffordt Koops

  • 1Divisions of Medical Oncology, University Hospital Groningen, The Netherlands.

British Journal of Cancer
|January 1, 1995
PubMed
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Bleomycin, etoposide, and cisplatin (BEP) chemotherapy can cause lung function changes. Vital capacity (VC) and pulmonary capillary blood volume (Vc) specifically reflect bleomycin-induced lung damage, unlike TLCO, Dm, or KCO.

Area of Science:

  • Oncology
  • Pulmonology
  • Pharmacology

Background:

  • Chemotherapy regimens like BEP are used for testicular cancer.
  • Bleomycin is known to cause pulmonary toxicity.
  • The specific lung function changes attributable to bleomycin within BEP require elucidation.

Purpose of the Study:

  • To compare pulmonary function changes in patients receiving BEP versus etoposide and cisplatin (EP) chemotherapy.
  • To identify specific lung function parameters sensitive to bleomycin-induced pulmonary toxicity.

Main Methods:

  • Randomized trial comparing BEP (27 patients) and EP (27 patients) for non-seminomatous testicular cancer.
  • Pulmonary function tests including vital capacity (VC), transfer factor for carbon monoxide (TLCO), diffusing capacity of the alveolo-capillary membrane (Dm), pulmonary capillary blood volume (Vc), and transfer factor per unit alveolar volume (KCO) were measured.

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  • Measurements were taken before and at 3-week intervals during chemotherapy.

    • Main Results:

    • Both groups showed a significant decrease in TLCO during therapy, with a significant difference only observed at the end of treatment.
    • Dm significantly diminished in both groups, with no significant intergroup differences.
    • VC and Vc decreased significantly in the BEP group but remained stable in the EP group.

    Conclusions:

    • Transfer factor of the lungs for carbon monoxide (TLCO), diffusing capacity of the alveolo-capillary membrane (Dm), and transfer factor per unit alveolar volume (KCO) are not ideal for monitoring bleomycin-induced pulmonary toxicity in multidrug regimens.
    • Vital capacity (VC) and pulmonary capillary blood volume (Vc) are suitable lung function assessments for detecting bleomycin-specific pulmonary alterations.