Lung Cancer Chemotherapy In Patients Undergoing Daialysis

Abstract Background: Malignant disease is the third leading cauuse of death (accounting for 9.1%) in patients who unedrgo dialysis in Japan. Purpose: To elucidate the feasibility of lung cancer chemotherapy in patients undergoing dialysis. Methods: We retrospectively reviewed the clinical course of lung cancer chemotherapy in 3 patients who underwent dialysis from January 2013 to December 2013. Results: The patients consisted of 3 male, with the median age 70(67-77).Underlying disease for dialysis were diabetic nephropathy in 2 patients,chronic glomerulonephritis in 1 patient. The three cases inculuded lung adenocarcinoma (C-T1bN0M1b,stage 4), lung squamous carcinoma(C-T2aN2M0 stage 3A) and small cell lung cancer(extensive disease) in each. Treatment regimens were 1 course of CBDCA/GEM, four courses of DTX with sequential thoracic irradiation, four courses of CBDCA/ETP in each patient. The best overall response was PR in 2 cases and SD in 1case. The major adverse events:Grade 3/4 neutropenia in 3(100%), G4 anemia in 2(66.7%), G3/4 thrombocytopenia in 3(100%), G3 febrile neutropenia in 2(66.7%), G5 stroke in 1(33.3%) in each. With the median follow-up period 263(58-628) days, 2 patients died, including 1 early death with stroke. Conclusion: Chemotherapy for lung cancer patients undergoing dialysis were associated with severe hematological toxicity. It is urgent task to establish optimal cancer chemotherapy and management of adverse events.