[Surgically resected lung cancer in patients complicated with diffuse interstitial pulmonary shadow].

In 25 patients operated on for idiopathic interstitial pneumonia (IIP) associated with primary lung cancer, we clinically examined the predictive factors related to the acute exacerbation of IIP preoperatively and during operation. Most were male heavy smokers. Ages ranged 57 to 78 years. Standard surgery was performed in 11 patients, extended resection in 4 patients and limited resection in 10 patients. The incidence of postoperative acute exacerbation of IIP was 40% (10 patients). These patients were treated with steroid pulse therapy, 3 patients died due to acute exacerbation but 7 patients recovered. It seemed difficult to anticipate postoperative exacerbation of IIP based on preoperative patients evaluation and the degree of surgical invasiveness. Seven patients were alleviated with erythromycin before and after the operation and 4 patients were alleviated with high-dose steroid during or after surgery, with these patients not developing exacerbation of IIP. From these results, it was suggested that high-dose steroid administration during or after surgery and erythromycin before and after the operation were effective to avoid postoperative exacerbation of IIP.

[A case of postoperative recurrent lung cancer with chronic renal failure and respiratory failure successfully treated with gefitinib].

We administered gefitinib to a patient after considering his request to be treated with the drug. Fortunately, he responded favorably to the treatment and did not show signs of serious adverse effects or deterioration of renal functions. The patient was a 69-year-old male who visited an outpatient clinic because of chronic renal failure and was diagnosed with primary lung cancer. He then underwent an operation for lung cancer, but because it had progressed to stage IV the lesion was not completely resected. The patient was unable to receive effective chemotherapy due to the prior chronic renal failure. During best support care, the patient suffered from respiratory failure due to the tumor growth, and his quality of life (QOL) deteriorated. The patient was administered 250 mg of gefitinib orally, which was effective in reducing the tumor, improving his QOL, and prolonging his survival time. With the lack of literature on administering gefitinib to patients with chronic renal failure and evidence supporting the effectiveness of this treatment, the physician in charge should obtain the patient's informed consent before initiating treatment using this anticancer drug.