Perioperative Considerations for Patients Treated with Bleomycin (8)

In: Bleomycin

10 Apr 2013

Irradiation of the chest can cause pulmonary fibrosis, and radiation has been implicated in the potentiation of bleomycin toxicity. The toxicity produced by the combination of bleomycin and radiation involves both lungs, not just the areas in the radiation port. Patients receiving radiation to the chest before, during, or after bleomycin therapy have a 19 percent incidence of significant pulmonary toxicity. In a review by Catane et al, 10 percent of all patients who received simultaneous irradiation and bleomycin therapy died from pulmonary complications. A significant interval of time between chest irradiation and bleomycin therapy does not appear to diminish the toxicity of the combination; in one case of fatal pulmonary toxicity, 17 years elapsed between the two treatments. buy cipro
Adding surgery to the combination of bleomycin and radiation therapy may cause further complications. Nygaard et al found an increased incidence of pulmonary complications in patients who received bleomycin and irradiation and subsequently had major surgical resection of their esophageal tumors, as compared to patients undergoing an exploratory procedure or no surgery after chemotherapy and irradiation.

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