Green M R
West J Med. 1977 Oct;127(4):292-8.
Pulmonary parenchymal or pleural reactions to chemotherapeutic agents used in the management of patients with malignant diseases are being recognized with increasing frequency. Alkylating agents, asparaginase, bleomycin, methotrexate and procarbazine have all been implicated. Some of the reactions, such as the rare procarbazine pleuritis and pneumonitis, represent hypersensitivity phenomena. Others, such as alkylating agent pulmonary toxicity, appear to be direct toxic effects of the drugs. The severity of the toxicity is variable. The appearance of these pulmonary changes must be differentiated from tumor progression or a variety of possible infections. The awareness of possible pulmonary toxicity is of great importance since early discontinuation of the agent following the first hint of pulmonary toxicity may allow partial or complete reversal of the process. Continued therapy in the face of drug-related pulmonary toxicity may enhance the likelihood of irreversible pulmonary compromise with respiratory failure and death.
在恶性疾病患者的治疗中，化疗药物引起的肺实质或胸膜反应正越来越频繁地被认识到。烷化剂、天冬酰胺酶、博来霉素、甲氨蝶呤和丙卡巴肼都与之有关。其中一些反应，如罕见的丙卡巴肼胸膜炎和肺炎，表现为超敏现象。其他反应，如烷化剂肺毒性，则似乎是药物的直接毒性作用。毒性的严重程度各不相同。这些肺部变化的出现必须与肿瘤进展或各种可能的感染相鉴别。认识到可能的肺毒性非常重要，因为在首次出现肺毒性迹象后尽早停用药物可能使病情部分或完全逆转。面对与药物相关的肺毒性仍继续治疗，可能会增加发生不可逆肺功能损害并导致呼吸衰竭和死亡的可能性。
