Chemotherapy-induced spontaneous pneumothorax (SP) has been described sporadically in chemosensitive tumors, particularly sarcoma, with multiple lung metastases. We present a patient who developed SP following rapid regression of bulky mediastinal lymphoma. Immediately on chest tube insertion, the lung recovered and further chemotherapy could be delivered uneventfully. We suggest that (1) chemotherapy-induced SP should be included amongst oncologic emergencies and that (2) a high degree of awareness of this complication is required.
The combination of carmustine, cisplatin, dacarbazine, interferon, and low-dose tamoxifen is widely used in treating metastatic melanoma and was originally reported to achieve a 20% complete response rate. Among 29 patients who completed the authors' phase II study with the regimen, five (17%) achieved complete remission, and the median duration of response was 8 months (range, 2-14 months). The aim of the study was to evaluate briefly the value and toxicity of this regimen in treating metastatic malignant melanoma.
Background: Platinum based doublet chemotherapy is considered standard but is often clinical inappropriate. Newer drugs as docetaxel and gemcitabine given as single agents in 1st-and 2nd-line have shown favorable toxicity and significant efficacy. It is assumed that sequencing of docetaxel and gemcitabine could be an equally effective alternative for palliation. Treatment: From 1998 to 2004 a total of 819 patients have been included in three studies (Figure ): two to identify an optimal single agent sequence; and one to compare sequential single agents to a platinum-free doublet.
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