ABSTRACT
A 71-year-old male was diagnosed with a non-small cell lung cancer (NSCLC) within the radiotherapy field that was used for the treatment of a small cell lung cancer (SCLC) 11 years ago. At the initial diagnosis in 1996 the patient had limited-stage SCLC located in the right upper lobe of the lung with mediastinal involvement. He received 4 cycles of chemotherapy and then mediastinal radiotherapy. With a complete response after chemoradiotherapy he was given prophylactic cranial radiotherapy. After 11 years of disease-free period a new mass in left lower lobe of the lung was detected. Bronchoscopic biopsy showed second lung cancer with epidermoid histology. Although the incidence of a second lung cancer is higher in SCLC survivors, this is a unique case in the literature with second NSCLC developing in the previously irradiated side of limited-stage SCLC.
Subject(s)
Carcinoma, Non-Small-Cell Lung/diagnosis , Carcinoma, Non-Small-Cell Lung/etiology , Lung Neoplasms/diagnosis , Neoplasms, Second Primary/etiology , Small Cell Lung Carcinoma/diagnosis , Aged , Combined Modality Therapy , Cranial Irradiation , Humans , Lung Neoplasms/drug therapy , Lung Neoplasms/radiotherapy , Male , Neoplasm Recurrence, Local/diagnosis , Neoplasm Recurrence, Local/drug therapy , Neoplasms, Second Primary/drug therapy , Small Cell Lung Carcinoma/drug therapy , Small Cell Lung Carcinoma/radiotherapyABSTRACT
AIMS: To investigate whether the application of vitamin E with or without pentoxifylline could modify the development of radiation-induced pulmonary fibrosis. MATERIALS AND METHODS: Wistar albino rats were supplemented with either vitamin E or pentoxifylline or with both vitamin E and pentoxifylline after a single dose of 14 Gy thoracic irradiation. Supplementation was started the day after irradiation and continued until the rats were sacrificed. As a quantitative end point, the extent of fibrosis was evaluated with a scale from 0 (normal lung) to 8 (total fibrous obliteration of the field) at pathological examination of the lung tissue. RESULTS: A significant reduction in fibrosis was obtained in the group of rats supplemented with vitamin E with or without pentoxifylline, when compared with the group that had irradiation only. CONCLUSION: This experimental study showed that vitamin E supplementation immediately after irradiation protected rats against radiation-induced pulmonary fibrosis. The combination with pentoxifylline was more effective, although pentoxifylline itself had limited efficacy, which was not statistically significant.
