Lucraft H H, Wilkinson P M, Stretton T B, Read G
Eur J Cancer Clin Oncol. 1982 Feb;18(2):133-9. doi: 10.1016/0277-5379(82)90056-6.
Thirty-eight men were treated for metastatic teratoma with up to four courses of chemotherapy, each containing 90 mg bleomycin. Routine pulmonary function tests (PFTs) were performed before each course to assess their value in detecting bleomycin pulmonary toxicity. PFTs were repeated 2-5 yr after completion of chemotherapy in 10 disease-free survivors. Analysis of changes in individual PFT values showed a fall in the carbon monoxide diffusing capacity (DLco) after 90 mg bleomycin (P less than 0.005). The DLco remained depressed with subsequent doses of bleomycin, but there was no further statistically significant fall. There was no significant change in any other PFT. Similarly, late PFT values showed no significant change. There was no correlation between changes in the visible extent of metastases as assessed from the chest radiography and changes in serial PFTs. It is concluded that routine PFTs are unnecessary if the total bleomycin dose in less than or equal to 360 mg, unless there are particular risk factors. Late drug-induced pulmonary damage is unlikely to develop after treatment withdrawal.
38名男性接受了转移性畸胎瘤的治疗，化疗最多进行四个疗程，每个疗程包含90毫克博来霉素。在每个疗程之前进行常规肺功能测试（PFT），以评估其在检测博来霉素肺毒性方面的价值。10名无病生存者在化疗结束后2至5年重复进行了PFT。对个体PFT值变化的分析显示，给予90毫克博来霉素后一氧化碳弥散量（DLco）下降（P<0.005）。后续给予博来霉素剂量时，DLco仍处于降低状态，但无进一步的统计学显著下降。其他任何PFT均无显著变化。同样，晚期PFT值也无显著变化。根据胸部X线片评估的转移灶可见范围变化与系列PFT变化之间无相关性。结论是，如果博来霉素总剂量小于或等于360毫克，除非存在特定危险因素，否则常规PFT是不必要的。停药后不太可能发生晚期药物性肺损伤。
