Table 2 Common types of lung damage during chemotherapy and their response to treatment

From: Diagnosis and management of drug-associated interstitial lung disease

Agent/lung damage

Therapy

Response

Mitomycin

  

 Acute pneumonitis (interstitial and noncardiac oedema)

Methylprednisolone 250 mg every 6 h for 2–3 days followed by prednisone 0.5 mg kg−1 for 6 weeks with gradual dose reduction

Partial

 Chronic pneumonitis

Prednisone 60 mg four times a day for 6 weeks followed by gradual dose reduction

Fair

Paclitaxel

  

 Infusion hypersensitivity

Pretreatment with an antihistamine, a corticosteroid and a histamine

Preventative

 Interstitial pneumonitis

H2-blocker Observation or corticosteroids

Gooda

Docetaxel

  

 Fluid retention syndrome

Pretreatment with dexamethasone

Goodb

 Interstitial pneumonitis

Corticosteroids

Fairb

 ARDS-like pattern

Corticosteroids

Fairb

Gemcitabine

  

 Dyspnoea

None

Good

 ARDS (mild capilliary leak)

Corticosteroids, with continuation of gemcitabine therapy in some cases

Good

 Interstitial pneumonitis in combination with docetaxel or paclitaxel)

Corticosteroids

Variable

  1. Buzdar et al (1980), Chang et al (1986), Goldberg and Vannice (1995), Rivera et al (1995), Ramanathan and Belani (1996), Bookman et al (1997), Merad et al (1997), Piccart et al (1997), Semb et al (1998), Vander Els and Miller (1998), Dunsford et al (1999), Thomas et al (2000), Fogarty et al (2001) and Read et al (2002).
  2. aEven when paclitaxel is used in conjunction with radiotherapy.
  3. bWhen docetaxel is used in combination with radiotherapy or gemcitabine, the response is variable to poor.
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