Journal of Cancer Research and Treatment

Current Issue» Volume 2, Number 3 (2014)

Article

Recurrent Lung Abscesses during Chemotherapy in Non-neutropenic Patient with Limited Stage Small Cell Lung Cancer: A Case Report and Review

1The general organization for teaching hospitals, Cairo, Egypt


Journal of Cancer Research and Treatment. 2014, 2(3), 52-54
DOI: 10.12691/jcrt-2-3-2
Copyright © 2014 Science and Education Publishing

Cite this paper:
Mohammed Osman. Recurrent Lung Abscesses during Chemotherapy in Non-neutropenic Patient with Limited Stage Small Cell Lung Cancer: A Case Report and Review. Journal of Cancer Research and Treatment. 2014; 2(3):52-54. doi: 10.12691/jcrt-2-3-2.

Correspondence to: Mohammed  Osman, The general organization for teaching hospitals, Cairo, Egypt. Email: mmoneam@hotmail.com

Abstract

Background: Small cell lung cancer (SCLC) represents 14% of all lung cancer cases. The current standard of care for limited stage SCLC is the chemotherapy combination of EP (etoposide, cisplatin) with concomitant radiotherapy. Treatment protocol is tolerated well and is associated with few side effects.Case Description: 58 y.o. lady diagnosed to have limited stage SCLC in our institute in November 2013. She was planned for concomitant chemoradiotherapy (CCRT). She started initially on chemotherapy protocol EP. On day 12 of cycle 2, the patient complained of Fever, excessive cough. CT thorax showed newly developed peripherally situated pulmonary abscess. She was kept in with IV antibiotics, and her condition was improved thereafter. Then she was started on CCRT, with cycle 3 EP. On day 6 of her cycle 3, she developed fatigue, poor general condition, high fever, cough and neutropenia. She was admitted as neutropenic sepsis, with improvement of neutropenia after only 1 shot of short acting GCSF. Sputum culture showed Klebsiella pneumonia. CT Thorax showed new lung abscess in the Left ligula. She was treated by IV antibiotic for 10 days. Her condition was improving thereafter and she was returned back to radiotherapy, as well as Cycle 4 EP. Currently, she finished her treatment since 1 month with no complication related to treatment protocol. Discussion: Although few, studies attributed the reason for lung abscess development to leuconeutropenia in some patients, and to relatively large primary tumour size in other patients. Conclusion: Many reasons may explain the development of lung abscess in non-neutropenic patient including chemotherapy side effect, underlying chest condition, and relatively large primary tumour size.

Keywords

References

[[[[[
[1]  Haller DG, Wagman LD, Camphausen KA, et al: Small-Cell Lung Cancer, Mesothelioma, and Thymoma, Chapter 4, Cancer Management: A Multidisciplinary Approach, 14th. Edition, 2012.
 
[2]  Fried DB, Morris DE, Poole C, et al: Systematic review evaluating the timing of thoracic radiation therapy in combined modality therapy for limited-stage small-cell lung cancer. J Clin Oncol 22:4837-4845, 2004.
 
[3]  Surendiran A, et al: Adverse drug reaction profile of cisplatin based chemotherapy regimen in a tertiary care hospital in India: An evaluation study. Indian J Pharmacol. Feb 2010; 42(1): 40-43.
 
[4]  Medscape.com @ http://reference.medscape.com/drug/platinol-aq-cisplatin-342108, http://reference.medscape.com/drug/vepesid-toposar-etoposide-342098,
 
[5]  Magaña E, Crowell RE: Radiation Pneumonitis Successfully Treated with Inhaled Corticosteroids, South Med J. 2003; 96(5).
 
Show More References
[6]  Hirshberg B, Sklair-Levi M, Nir-Paz R, et al: Factors predicting mortality of patients with lung abscess. Chest. 1999; 115 (3): 746-50.
 
[7]  Moreira JS, Camargo JJ, Felicetti JC, Goldenfun PR, et al: Lung abscess: analysis of 252 consecutive cases diagnosed between 1968 and 2004. Jornal brasileiro de pneumologia. 2006; 32 (2): 136-43.
 
[8]  Phernambucq CJ, Hartemink KJ, Smit EF, et al: Tumor cavitation in patients with stage III non-small-cell lung cancer undergoing concurrent chemoradiotherapy: incidence and outcomes. JOURNAL OF THORACIC ONCOLOGY. 2012; Vol. 7: Issue 8, 1271-1275.
 
[9]  Hansen SW, Aabo K, Osterlind K: Lung abscess in small cell carcinoma of the lung during chemotherapy and corticosteroids: an analysis of 276 consecutive patients. Eur J Respir Dis. 1986 Jan; 68(1):7-11.
 
[10]  Justice RL: Reported adverse side effects of cisplatin and etoposide. NDA 018057/Supplement081, 2013, www.FDA.org.
 
Show Less References

Article

Abrogation by Ginkgo Byloba Leaf Extract on Hepatic and Renal Toxicity Induced by Methotrexate in Rats

1Zoology Department, Faculty of Science, Tanta University, Tanta, Egypt


Journal of Cancer Research and Treatment. 2014, 2(3), 44-51
DOI: 10.12691/jcrt-2-3-1
Copyright © 2014 Science and Education Publishing

Cite this paper:
Ehab Tousson, Zeinab Atteya, Afaf El-Atrash, Ola I. Jeweely. Abrogation by Ginkgo Byloba Leaf Extract on Hepatic and Renal Toxicity Induced by Methotrexate in Rats. Journal of Cancer Research and Treatment. 2014; 2(3):44-51. doi: 10.12691/jcrt-2-3-1.

Correspondence to: Ehab  Tousson, Zoology Department, Faculty of Science, Tanta University, Tanta, Egypt. Email: toussonehab@yahoo.com

Abstract

Methotrexate (MTX) is used as a chemotherapeutic agent and its anti-oxidant activity is used to treat many cancer types. The present study aimed to examine the possible modifying effects of Ginkgo biloba leaf extract (GLE) against hepatic and renal toxicity induced by MTX in rats. A total 60 male albino rats were equally divided into six groups; the first and second groups were the control and GLE groups respectively while the 3rd group was MTX rat group; the 4th and 5th groups were Co- and post treated MTX rat with GLE respectively and the 6th group was MTX self treated rat group. Serum GPT, GOT, urea, creatinine, uric acids and MDA levels in MTX group showed a significant increase when compared with control group, in contrast, MTX-treated group also exhibited a significant decrease in liver antioxidant machinery represented by GSH, catalase, SOD and total protein. Administration of GLE combined with MTX improved the liver and kidney damages induced by MTX. Histopathological and evidence, together with observed CD68 immunoreactivity, supported the detrimental effect of MTX and the ameliorating effect of GLE on liver and kidney toxicities. GLE possessed various protective mechanisms against MTX-induced liver and kidney toxicity throughout Co- and post- treatment. We can conclude that Co-treatment with GLE has beneficial properties and can reduce the liver and kidney damages and toxicity induced by MTX.

Keywords

References

[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[
[1]  Tousson E, Hafez E, Zaki S, Gad A. P53, Bcl-2 and CD68 expression in response to Amethopterin-induced lung injury and ameliorating role of L-carnitine. Biomed and pharmacology 2014.
 
[2]  West SG. Methotrexate hepatoxicity. Rheum Dis Clin North Am 1997; 23: 883-915.
 
[3]  Yozai K, Shikata K, Sasaki M, Tone A, Ohga S, Usui H. Methotrexate prevents renal injury in experimental diabetic rats via anti-inflammatory actions. J Am Soc Nephrol 2005; 16: 3326-3338.
 
[4]  ALL C, Ertan B, Ergul BK, Bulent K. N-acetylcysteine ameliorates methotrexate-induced oxidative liver damage in rats. Med Sci Monit 2006; 12 (8): 247-248.
 
[5]  Ozogula B, Kisaoglua A, Turanb M.I, Altunerc D, Senerd E, Cetine N, Ozturk C. The effect of mirtazapine on methotrexate-induced toxicity in rat liver. Science Asia 2013; 39: 336-356.
 
Show More References
[6]  Johovic N, Cevik H, Sehirli OA, Yegen BÇ, Şener G. Melatonin prevents methotrexate-induced hepatorenal oxidative injury in rats. Journal of Pineal Research 2003; 34, 282-287.
 
[7]  Cetin A, Kaynar L, Kocyigit I, Hacioglu S.K, Saraymen R, Ozturk A, Chan ES, Montesinos MC, Fernandez P. Adenosine A (2A) receptors play a role in the pathogenesis of hepatic cirrhosis. Br J Pharmacol 2006; 148 (8): 1144-1155.
 
[8]  Hemeida A.R, Omar M.M. Curcumin Attenuates Methotraxate-Induced Hepatic Oxidative Damage in Rats. Journal of the Egyptian Nat Cancer Inst 2008; 20 (2): 141-148.
 
[9]  Vardi N, Parlakpinar H, Ozturk F, Ates B, Gul M, Cetin A, Erdogan A, Otlu A. Potent protective effect of apricot and β-carotene on methotrexate induced intestinal oxidative damage in rats. Food and Chemical Toxicology 2008; 46: 3015-3022.
 
[10]  Vardi N, Parlakpinar H, Ates B, Cetin A, Otlu A. Anti apoptotic and antioxidant effects of beta-carotene against methotrexate-induced testicular injury. Fertil Steri 2009; 92: 2028-2033.
 
[11]  Iyyaswamy A, Rathinasamy S. Effect of chronic exposure to aspartame on oxidative stress in the brain of albino rats. J Biosci 2012; 37: 679-688.
 
[12]  Stickel F, Schuppan D. Herbal medicine in the treatment of liver diseases. Dig Liver Dis 2007; 39: 230-293
 
[13]  Abad MJ, Bedoya LM, Bermejo P. An update on drug interactions with the herbal medicine Ginkgo biloba. Current Drug Metabolism 2010; 11: 171-181.
 
[14]  Sakr SA, Abo-El-Yazid SM. Effect of fenugreek seed extract on adriamycin-induced hepatotoxicity and oxidative stress in albino rats. Toxicology and Industrial Health 2012; 28 (10): 876-885.
 
[15]  Sakeran MI, Zidan N, Rehman H, Aziz AT, Saggu S. Abrogation by Trifolium alexandrinum root extract on hepatotoxicity induced by acetaminophen in rats. Redox Rep 2014; 19 (1): 26-33.
 
[16]  Elsabagh S, Hartley D.E, Ali O, Williamson E.M, File S.E. Differential cognitive effects of Ginkgo biloba after acute and chronic treatment in healthy young volunteers. Psychopharmacology 2005; 179: 437-446.
 
[17]  Altiok N, Ersoz M, Karpuz V, Koyuturk M. Ginkgo biloba extract regulates differentially the cell death induced by hydrogen peroxide and simvastatin. Neurotoxicology 2006; 27: 158-163.
 
[18]  Kalisz O, Wolski T, Gerkowicz M. Miłorząb japoński (Ginkgo biloba) i jego preparaty wterapii zabur zeńkrążenia mózgowego i obwodowego [Ginkgo biloba (Ginkgo biloba) and its preparations in therapy of cerebral and peripheral circulation disorders]. Ann. Univ. Mariae Curie-Skłodowska 2006; 61 (2): 11-17.
 
[19]  Abdel-Kader R, Hauptmann S, Keil U, Scherping I, Leuner K, Eckert A, Müller WE. Stabilization of mitochondrial function by Ginkgo biloba extract. Pharmacol Res 2007; 56 (6): 493-502.
 
[20]  Liu JJ, Ching LM, Goldthorpe M, Sutherland R, Baguley BC, Kirker JA, McKeage MJ. Antitumour action of 5,6-dimethylxanthenone-4-acetic acid in rats bearing chemically induced primary mammary tumours. Cancer Chemother Pharmacol 2007; 59: 661-669.
 
[21]  Mahadevan S, Park Y. Multifaceted therapeutic benefits of Ginkgo biloba L.: chemistry, efficacy, safety, and uses. J Food Sci 2008; 73 (R) 14-19.
 
[22]  Kobus J, Flaczyk E, Siger A, Nogala-Kalucka M, Korczak J, Pegg R.B. Phenolic compounds and antioxidant activity of extracts of Ginkgo leaves. Eur J Lipid Sci Technol 2009; 111 (11): 1150-1160.
 
[23]  Cha´vez-Morales RM, Jaramillo-Jua´rez F, Posadas del Rı´o FA, Reyes-Romero MA, Rodrı´guez-Va´zquez ML, Martı´nezSaldan˜a MC. Protective effect of Ginkgo bilobaextract on liver damage by a single dose of CCl4in male rates. Hum Exp Toxicol 2011; 30: 209-216.
 
[24]  Sener G, Eksioglu-Demiralp E, Cetiner M, Ercan F, Yegen BC. Beta-glucan ameliorates methotrexate-induced oxidative organ injury via its antioxidant and immunomodulatory effects. Eur J Pharmacol 2006; 542 (33): 170-178.
 
[25]  Yozai K, Shikata K, Sasaki M, Tone A, Ohga S, Usui H. Methotrexate prevents renal injury in experimental diabetic rats via anti-inflammatory actions. J Am Soc Nephrol,2005; 16: 3326-3338.
 
[26]  Reitman S, Frankel S. A colorimetric method for the determination of serum glutamic oxalacetic and glutamic pyruvic transaminases. Amer J Clin Pathol 1957; 28: 56-63.
 
[27]  Doumas BT, Watson WA, Biggs HG. Albumin standards and the measurement of serum albumin with bromocresol green. Clin Chim Acta 1971; 31: 87-96.
 
[28]  Fawcett J.K, Scott J.E. A rapid and precise method for the determination of urea. J Clin Path 1960; 113: 156.
 
[29]  Bowers LD, Wong ET. Kinetic serum creatinine assays. II. A critical valuation and review. Clin Chem 1980; 26 (5): 555-561.
 
[30]  Mesbah L, Soraya B, Narimane S, Jean PF. Protective effect of flavonoides against the toxicity of vinblastine cyclophosphamide and paracetamol by inhibition of lipid- peroxidation and increase of liver glutathione. Haema 2004; 7: 59-67.
 
[31]  Beutler E, Duron O, Kelly BM. Improved method for the determination of blood glutathione. J Lab Clin Med 1963; 61: 882-888.
 
[32]  Lowry OH, Rosebrough NJ, Farr AL, Randall RJ. Protein measurement with Folin phenol reagent. J. Biol. Chem. 1951; 193: 265-275.
 
[33]  Tsuyosh P, James KB. A simplified method of quantitating Protein using the Buiret and phenol reagents, Anal Biochem 1978; 86: 193-200.
 
[34]  Bancroft JD, Stevens A. Theory and Practice of Histological Technique. 3rd Ed. Churchill Living stone. Edinburgh, London benefits in Stage +2 postmenopausal women after 6 weeks of treatment with Ginkgo biloba. J Psychopharmacol 1990; 19: 173-181.
 
[35]  Balk RA. Methotrexate-induced lung injury. UpT o Date, 2006. Available at: www.uptodate.com. Accessed 8 May 2006.
 
[36]  Kremer JM. Major side effects of methotrexate. UpToDate, 2006. Available at: www.uptodate.com. Accessed 8 May 2006.Laboratory Medicine. Chapter 66. Lexi-Comp Inc.
 
[37]  Genestier L, Paillot R, Quemeneur L, Izeradjene K, Revillard JP. Mechanisms of action of methotrexate. Immunopharmacology 2000; 47: 247-257.
 
[38]  Walling J. From methotrexate to pemetrexed and beyond. A review of the pharmacodynamic and clinical properties of antifolates. Investigational New Drugs 2006; 24: 37-77.
 
[39]  Wielinga P, Hooijberg JH, Gunnarsdottir S. The human multidrug resistance protein MRP5 transports folates and can mediate cellular resistance against antifolates. Cancer Res 2005; 65: 4425-4430.
 
[40]  Maiti R, Jana D, Das U.K, Ghosh D. Antidiabetic effect of aqueous effect of seed of Tamarindus indica in streptozotocininduced diabetic rats. J Ethnopharmacol 2004; 92: 85-91.
 
[41]  Fu Y, Zheng S, Lin J, Ryerse J, Chen A. Curcumin protects the rat liver from CCl4-caused injury and fibrogenesis by attenuating oxidative stress and suppressing inflammation. Mol Pharmacol 2008; 73 (2): 399-409.
 
[42]  Vardi A, Bosviel R, Rabiau N, Adjakly M, Satih S, Dechelotte P. Soy phytoestrogens modify DNA methylation of GSTP1, RASSF1A, EPH2 and BRCA1 promoter in prostate cancer cells. In Vivo 2010; 24: 393-400.
 
[43]  Drotman R, Lawhan G. Serum enzymes are indications of chemical induced liver damage. Drug Chem Toxicol 1978; 1: 117-163.
 
[44]  Sakeran M.I, Zidan N, Rehman H, Aziz AT, Saggu S. Abrogation by Trifolium alexandrinum root extract on hepatotoxicity induced by acetaminophen in rats. Redox Rep 2014; 19 (1): 26-33.
 
[45]  Saggu S, Kumar R. Modulatory effect of seabuckthorn leaf extract on oxidative stress parameters in rats during exposure to cold, hypoxia and restraint (C-H-R) stress and post stress recovery. J Pharm Pharmacol 2007; 59 (12): 1739-1745.
 
[46]  Jadon A, Bhadauria M, Shukla S. Protective effect of Terminalia belerica Roxb. and gallic acid against carbon tetrachloride induced damage in albino rats. J Ethnopharmacol 2007; 109: 214-218.
 
[47]  Kadikoylu G, Bolaman Z, Demir S, Balkaya M, Akalin N, Enli Y. The effects of desferrioxamine on cisplatininduced lipid peroxidation and the activities of antioxidant enzymes in rat kidneys. Hum Exp Toxicol 2004; 23: 29-34.
 
[48]  Klukowska L, Nadulska A, Dyba S. The influence of cisplatinum and goserelinum on the magnesium and calcium level in rat serum. Ann Univ Mariae Curie Sklodowska [Med]. 2001; 56: 483-486.
 
[49]  Saad MF, Greco S, Osei K, Lewin AJ, Edwards C, Nunez M, Reinhardt RR. Ragaglitazar improves glycemic control and lipid profile in type 2 diabetic subjects: a 12-week, double-blind, placebocontrolled dose-ranging study with an open pioglitazone arm. Diabetes 2004; 27: 1324-1329.
 
[50]  Thabrew M, Joice P. A comparative study of the efficacy of Pavetta indica and Osbeckia octanda in the treatment of liver dysfunction. Planta Med 1987; 53 (3): 239-241.
 
[51]  Kolli VK, Abraham P, Rabi S. Methotrexate-induced nitrosative stress may play a critical role in small intestinal damage in the rat. Archives of Toxicology 2008; 82 (10): 763-770.
 
[52]  Jahovic N, Sener G, Cevic H, Ersoy Y, Arbak S, Yegen BC. Amelioration of methotrexate-induced enteritis by melatonin in rats. Cell Biochem Function 2004; 22-28.
 
[53]  Cetiner M, Sener G, Sehirli AO, Eksioglu-Demiralp E, Ercan F, Sirvanci S, Gedik N, Akpulat S, Tecimer T, Yegen BC. Taurine protects against methotrexate-induced toxicity and inhibits leucocyte death. Toxicol Appl Pharmacol 2005; 209 (1): 39-50.
 
[54]  Sener G, Eksioglu-Demiralp E, Cetiner M, Ercan F, Yegen BC. Beta-glucan ameliorates methotrexate-induced oxidative organ injury via its antioxidant and immunomodulatory effects. Eur J Pharmacol 2006; 542 (33): 170-178.
 
[55]  Vardi A, Bosviel R, Rabiau N, Adjakly M, Satih S, Dechelotte P. Soy phytoestrogens modify DNA methylation of GSTP1, RASSF1A, EPH2 and BRCA1 promoter in prostate cancer cells. In Vivo. 2010; 24: 393-400.
 
[56]  Fridovich I. Superoxide radical and superoxide dismutases. Annu Rev Biochem 1995; 64: 97-112.
 
[57]  Ciralik H, Bulbuloglu E, Cetinkaya A, Kurutas E.B, Celik M, Polat A. Effects of N acetylcysteine on methotrexate induced small intestinal damage in rats. The Mount Sinai Journal of Medicine. 2006; 73: 1086-1092.
 
[58]  Lone I.A, Kaur G, Athar M, Alam M.S. Protective effect of Rumex patientia (English Spinach) roots on ferric nitrilotriacetate (Fe-NTA) induced hepatic oxidative stress and tumor promotion response. Food Chem Toxicol 2007; 45: 1821-1829.
 
[59]  Babiak RM, Campello AP, Carnieri EG, Oliveira M.B. Methotrexate: pentose cycle and oxidative stress. Cell Biochem Function 1998; 16: 283-293.
 
[60]  Prahalathan C, Selvakumar E, Varalakshmi P. Protective effect of lipoic acid on adriamycin-induced testicular toxicity. Clinica Chimica Acta 2005; 360: 160-166.
 
[61]  O’Rourke RA, Eckert GE. Methotrexate-induced hepatic injury in an adult A case report. Arch Int Med 1964; 113: 191-194.
 
[62]  Ros S, Juanola X, Condom E, Canas C, Riera J, Guardiola J, Del Blanco J, Rebasa P, Valverde J, Roig-Escofet O. Light and electron microscopic analysis of liver biopsy samples from rheumatoid arthritis patients receiving long-term methotrexate therapy. Scand J Rheumatol 2002; 31 (6): 330-336.
 
[63]  Hytiroglou P, Tobias H, Saxena R, Abramidou M, Papadimitriou CS, Theise ND. The canals of hering might represent a target of methotrexate hepatic toxicity. Am J Clin Pathol 2004; 121 (3): 324-329.
 
[64]  Horie T, Li T, Ito K, Sumi S, Fuwa T. Aged garlic extract protects against methotrexate-induced apoptotic cell injury of IEC-6 cells. J Nutr 2006; 53: 239-241.
 
Show Less References