Ramifications of severe organ dysfunction in newly diagnosed patients with small cell lung cancer

Contemporary experience from a single institution

Karin F. Giordano, Aminah Jatoi, Alex Adjei, Edward T. Creagan, Gary Croghan, Stephen Frytak, James R. Jett, Randolph Stuart Marks, Julian R Molina, Scott Heitaka Okuno, Ronald L. Richardson

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Small cell lung cancer is highly sensitive to chemotherapy, and a survival advantage with its use is well established. However, whether chemotherapy also confers such benefits to patients with severe organ dysfunction has not been extensively studied. The goal of this study was to provide further guidance for clinical decision-making. Medical records from small cell lung cancer patients who were seen at a single tertiary care institution between 1994 and 2002 were reviewed. All patients with severe organ dysfunction were identified. The latter was defined as creatinine ≥3 mg/dl, total bilirubin ≥3 mg/dl, and/or platelet count ≤50 × 106 per milliliter. An in depth review of treatment and outcome in this patient subgroup was then undertaken. A total of 993 small cell lung cancer patients were seen during this period, and 25 (2.5%) had severe organ dysfunction. Eleven had been treated with chemotherapy, 11 had not, and this information was not retrievable in 3. Cyclophosphamide, etoposide (oral or intravenous), paclitaxel, cisplatin, or carboplatin were prescribed as single agents or in combination; 8 of 11 patients received an initial dose reduction. With chemotherapy, three patients normalized their bilirubin, and one manifested a notable drop. Median survival was 150 days for chemotherapy-treated patients but only 10 days for those who did not receive it. One patient died a few days after chemotherapy; three others were hospitalized immediately thereafter; and two were lost to follow up. In five patients, no notable adverse events were noted in the medical record. These preliminary findings suggest that, even in the presence of severe organ dysfunction, a subgroup of small cell lung cancer patients can tolerate chemotherapy, normalize their laboratory parameters, and go on to live for several months.

Original languageEnglish (US)
Pages (from-to)209-215
Number of pages7
JournalLung Cancer
Volume49
Issue number2
DOIs
StatePublished - Aug 2005

Fingerprint

Small Cell Lung Carcinoma
Drug Therapy
Bilirubin
Medical Records
Survival
Carboplatin
Lost to Follow-Up
Etoposide
Tertiary Healthcare
Platelet Count
Cyclophosphamide
Creatinine

Keywords

  • Bilirubin
  • Creatinine
  • Lung cancer
  • Organ dysfunction
  • Renal insufficiency
  • Small cell
  • Thrombocytopenia

ASJC Scopus subject areas

  • Oncology

Cite this

Ramifications of severe organ dysfunction in newly diagnosed patients with small cell lung cancer : Contemporary experience from a single institution. / Giordano, Karin F.; Jatoi, Aminah; Adjei, Alex; Creagan, Edward T.; Croghan, Gary; Frytak, Stephen; Jett, James R.; Marks, Randolph Stuart; Molina, Julian R; Okuno, Scott Heitaka; Richardson, Ronald L.

In: Lung Cancer, Vol. 49, No. 2, 08.2005, p. 209-215.

Research output: Contribution to journalArticle

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