Lin W Y, Kao C H, Wang S J, Yeh S H
Department of Nuclear Medicine, Taichung Veterans General Hospital, Taiwan.
Neoplasma. 1995;42(3):133-5.
We investigated the lung toxicity of chemotherapeutic drugs in patients with breast cancer by means of Tc-99m DTPA aerosol scintigraphy. Thirty three patients who underwent surgical resection for breast cancer were divided into two groups, those who received a combination of adjuvant chemotherapy and those who did not. Group 1 consisted of 19 patients who received adjuvant chemotherapy and group 2 consisted of 14 patients who did not received adjuvant chemotherapy. Chemotherapeutic agents included 5-fluorouracil 1000 mg, endoxan 1000 mg and MTX 50 mg, all given intravenously. Aerosol lung scintigraphy was performed in all patients, in the supine position. The degree of lung damage was presented as the half clearance time (T 1/2) in minutes from the dynamic lung images. Only the right lung was used to analyze clearance, in order to avoid interference from stomach activity on the left side. The results show T 1/2 times of 68.18 +/- 20.04 min and 94.46 +/- 34.78 min, over the right lung, for groups 1 and 2, respectively. The difference is significant, with a p-value of 0.016, using the Mann-Whitney U test. We conclude that some chemotherapeutic drugs such as MTX, may result in pulmonary damage and that aerosol lung scintigraphy can provide an objective mean for early detection of pulmonary damage during cytotoxic chemotherapy.
我们通过锝-99m二乙三胺五醋酸（Tc-99m DTPA）气溶胶闪烁扫描术研究了化疗药物对乳腺癌患者的肺毒性。33例行乳腺癌手术切除的患者被分为两组，一组接受辅助化疗，另一组未接受辅助化疗。第1组由19例接受辅助化疗的患者组成，第2组由14例未接受辅助化疗的患者组成。化疗药物包括5-氟尿嘧啶1000毫克、环磷酰胺1000毫克和甲氨蝶呤50毫克，均通过静脉给药。所有患者均在仰卧位进行气溶胶肺闪烁扫描。肺损伤程度以动态肺图像中以分钟为单位的半清除时间（T1/2）表示。仅使用右肺分析清除情况，以避免左侧胃活动的干扰。结果显示，第1组和第2组右肺的T1/2时间分别为68.18±20.04分钟和94.46±34.78分钟。使用曼-惠特尼U检验，差异具有显著性，p值为0.016。我们得出结论，某些化疗药物如甲氨蝶呤可能会导致肺损伤，并且气溶胶肺闪烁扫描术可为细胞毒性化疗期间肺损伤的早期检测提供客观手段。
