Comis R L, Kuppinger M S, Ginsberg S J, Crooke S T, Gilbert R, Auchincloss J H, Prestayko A W
Cancer Res. 1979 Dec;39(12):5076-80.
Serial pulmonary function tests including single-breath carbon monoxide-diffusing capacity (DLCO), forced vital capacity (FVC), and forced expiratory volume in 1 sec were performed in a relatively homogeneous group of male patients with germ cell tumors treated with vinblastine, bleomycin, and cis-diamminedichloroplatinum. Of the pulmonary function tests used, the DLCO was shown to be the most sensitive indicator of subclinical bleomycin pulmonary effects. Decreases in DLCO were both total dose and schedule dependent. Patients receiving their total dose of bleomycin at a rate of 25 +/- 2 (S.D.) units/week developed a linear decrease in DLCO with increasing total doses of bleomycin. Changes in FVC did not correlate with bleomycin total dose. Although both the mean DLCO and FVC decreased after completion of bleomycin therapy, the mean FVC returned to base-line levels rapidly, whereas the decrease in mean DLCO was persistent for several months. When routine volumetric tests (FVC and forced expiratory volume in 1 sec) and DLCO are used in a systematic manner, DLCO is the most sensitive indicator of the subclinical pulmonary effects of bleomycin in germ cell tumor patients treated with vinblastine, bleomycin, and cis-diamminedichloroplatinum.
对一组相对同质的接受长春碱、博来霉素和顺二氯二氨铂治疗的男性生殖细胞肿瘤患者进行了系列肺功能测试，包括单次呼吸一氧化碳弥散量（DLCO）、用力肺活量（FVC）和1秒用力呼气量。在所使用的肺功能测试中，DLCO被证明是博来霉素亚临床肺部效应最敏感的指标。DLCO的下降与总剂量和给药方案均相关。以25±2（标准差）单位/周的速率接受博来霉素总剂量的患者，随着博来霉素总剂量增加，DLCO呈线性下降。FVC的变化与博来霉素总剂量无关。虽然博来霉素治疗结束后平均DLCO和FVC均下降，但平均FVC迅速恢复至基线水平，而平均DLCO的下降持续数月。当系统地使用常规容量测试（FVC和1秒用力呼气量）和DLCO时，DLCO是接受长春碱、博来霉素和顺二氯二氨铂治疗的生殖细胞肿瘤患者博来霉素亚临床肺部效应最敏感的指标。
