Kemoterapötik ilaçlara bağlı gelişen pulmoner komplikasyonlar

Chemotherapeutic drugs are used for the treatment of solid tumors and hematologic malignancies. In recent years, the use of these drugs as immunosuppressants, have steadily increased in inflammatory diseases. During the use of chemotherapeutic drugs, the most important problem is the organ toxicity. Drug-induced lung disease (DILD) has been recently characterized by the onset of modern medicine. DILD may present a wide variety of lung diseases from benign infiltrates to life-threatening conditions. There is not enough data about the incidence of DILD. For this purpose, we retrospectively reviewed 1231 patients from oncology department whom were treated with chemotherapeutic agents and included 20 patients with a diagnosis of DILD who were admitted with cough, fever, shortness of breath, chest pain. The male/female ratio was 11/9 and the mean age was found to be 53.2 years. Fifty-five percent of patients were men. No significant difference was found regarding the distrubution of gender (p>0,05). Seventy percent of patients were presented with cough, 60% with dyspnea, 50% with fever and 40% with sputum. The mean values of pulmonary function tests (PFT) were as follows: Forced expiratory volume (FEV1) was 69%, forced vital capacity (FVC) was 73%, FEV1/FVC was 79%, carbonmonoxide diffusion capacity was (DLCO) 63%. There was no statistically significant difference between these PFT values (p>0.05). Chest X-rays revealed pleural effusion in 5, reticular pattern in 10 and consolidation in 10 patients. High-resolution computed tomography demonstrated ground glass opacity (GGO) in 6, GGO + interstitial pattern + fibrosis in 9 patients and no abnormality was detected in 5 patients. Two patients were diagnosed as DILD by video asisted thoracoscopic surgery (VATS) and 18 patients were diagnosed by clinical and radiological findings. The frequency of DILD was found to be 0.27%. Bleomycin (n=2), cyclophosphamide (n=2), methotrexat (n=2), ARA-C (n=2), Desatinip (n=2), Erlotinip (n=2), Temadozol (n=1), Cisplatin (n =2), Transtuzumab (n =2), Oxaliplatin (n=1) and Dokataksel (n=1) were the drugs caused the pulmonary toxicity. Ninety-five of the patients improved with systemic corticosteroid treatment (p <0.05). These results suggested the importance of the awareness of the diagnosis and the early tratment of DILD in the patients using chemotherapeutic agents with a high clinical suspicion of the disease.