자궁경부암 항암제치료 환자에서의 Bleomycin Induced Pulmonary Toxicity 4 례 = Bleomycin Induced Pulmonary Toxicities During Chemotherapy in Patients with Cervical Cancer

국문 초록 (Abstract)

Bleomycin 사용으로 인한 폐 섬유화로 인하여 사망한 4례를 관찰한 결과 폐독성은 투여량에 반드시 비례하지는 않았다. Bleomycin에 의한 폐독성의 증상이 나타났을시에는 전례에서 치료에 반응하지 않고 급속히 사망하였다.
저자들은 항암효과가 탁월하고 cost effective한 항암제인 bleomycin의 사용으로 인한 폐섬유화증에 의한 사망 4례를 보고하며, 이 약제의 계속적인 사용이 필요한지 또는 부작용을 줄이며 효과면에서는 대등하다고 하는 대체 약제를 선택하여야 할 지 등에 대한 문제를 제기하는 바이다.

다국어 초록 (Multilingual Abstract)

Bleomycin has been widely used as chemotherapeutic agent for the treatment of uterine cervical cancer, Hodgkin`s disease, Malignant lymphoma and squamous cell cancer of skin, esophagus and Lung.
Although Bleomycin has side effects of headache, nausea, vomiting and high fever and toxicities of skin pigmentation, hyperkeratosis and skin ulceration but most of all, interstitial pulmonary fibrosis is the most serious complication.
From October, 1984 to August, 1990 in the Department of Obstetrics and Gynecology, Catholic University Medical College, we experienced 4 cases of death from Bleomycin induced pulmonary fibrosis during the courses of combination chemotherapy of VBP in patients with cervical cancer.
Mean age was 51.8 and clinical stages were Ⅱ1, Ib, Ⅱa and Ⅲ (as FIGO classification).
In case 1 the patient received radiation therapy concurrently with chemotherapy. In case 2 the patient received chemotherapy before and after radical hysterectomy.
In case 3 the patient received chemotherapy after modified radical hysterectomy and radiation therapy.
In case 4 the patient received chemotherapy after radiation therapy.
Mean amount of administered Blecomycin was 343.8mg and mean duration from initial use of Bleomycin to the symptom apperance of pulmonary fibrosis was 7 and half months.
Mean durations from appearance of symptom of pulmonary fibrosis to death was 3 weeks.