Study of the lung cancer patients on hemodialysis (HD) in Japan

Introduction: Early stage lung cancer in patients with end-stage renal disease are often detected by routine chest radiography on hemodialysis (HD) filtration. It is general that standard treatment for hemodialysis patients with lung cancer are not performed because guideline for lung cancer in HD patients is not established yet. Thus, clinicians have difficulty in treating HD patients even though early stage lung cancer is detected. Method: We retrospectively analyzed 17 HD patients with lung cancer between April 2004 and September 2010. Patients9 characteristics, histology and stage of lung cancer, treatment and outcome were evaluated. Results: A total 17 patients (13 male, 4 female) were eligible in this study. The median age was 72 years (range 54-90). Eleven patients of non-small cell lung cancer (NSCLC) and 1 small cell lung cancer (SCLC) had histological or cytological confirmation and 5 were unknown. They consist of 3 stageI, 1 stageII, 8 stageIII and IV. As for treatment, operation was taken in 3, chemotherapy alone and radiochemotherapy were received in 4 and 1. Nine patients did not receive any treatment since they are too old, had a poor performance status or considered to be intolerable by attending physicians.In terms of chemotherapy, hepatic excretory anti-cancer drugs were used in all the 4 patients. No severe adverse events related-treatment was seen in this study. Conclusion: Guideline for HD patients with advanced stage lung cancer should be established.