Carboplatin and weekly paclitaxel chemotherapy in hemodialysis patient with advanced lung cancer and severe comorbidity: effect of the drugs and their chemical intermediates

Abstract

In advanced non-small-cell lung cancer (NSCLC) patients with severe comorbidity or who are elderly, significant differences exist at the induction of chemotherapy. A 68-year-old man with a history of severe aortic stenosis and cerebral infarction had been receiving hemodialysis for end-stage renal disease. On admission due to loss of consciousness caused by aortic stenosis, a mass in the upper lobe of the right lung with a small amount of pleural effusion was detected. The patient was diagnosed with adenocarcinoma of lung (cT2bN1M1a, stage IV). A weekly regimen of paclitaxel in combination with carboplatin is less toxic than the standard regimen of administering both simultaneously. Therefore, this regimen is preferable for patients with severe comorbidity or who are elderly. For the present case, combination chemotherapy of carboplatin and weekly paclitaxel was selected and administered for four cycles. Tumor response was evaluated as stable disease and adverse events were tolerable. This combination was found to be a candidate regimen for advanced NSCLC patients receiving hemodialysis with severe comorbidity.