Division of Internal Medicine and Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan.
J Thorac Oncol. 2012 Jan;7(1):177-82. doi: 10.1097/JTO.0b013e31823c4c07.
The aim of the study is to evaluate the current status of treatment-related death (TRD) in lung cancer patients.
We retrospectively analyzed the incidence and risk factors of TRD in lung cancer patients who received chemotherapy and/or thoracic radiotherapy using logistic regression analyses.
Between January 2001 and December 2005, 1225 (222 small cell and 1003 non-small cell lung cancers) patients received chemotherapy and/or thoracic radiotherapy as the initial treatment. Of these, 43 patients receiving chemotherapy followed by thoracic radiotherapy were included into both the chemotherapy-alone and radiotherapy-alone groups. There were a total of 23 (1.9%) TRDs. Chemotherapy-related deaths occurred in 7 of 927 (0.8%) patients, including 4 from drug-induced lung injury, 2 from pneumonia, and 1 from unknown cause. Concurrent chemoradiotherapy-related deaths occurred in 12 of 245 (4.9%) patients, including 11 from radiation pneumonitis and 1 from pneumonia. Thoracic radiotherapy-related deaths occurred in 4 of 96 (4.2%) patients. The incidence of chemotherapy-related death was correlated with poor performance status (odds ratio [OR]: 11.4, 95% confidence interval [CI]: 3.53-37.1), the presence of hypoxia (OR: 19.3, CI: 6.06-61.7), hyponatremia (OR: 45.5, CI: 13.4-154), and treatment with epidermal growth factor receptor-tyrosine kinase inhibitors (OR: 8.56, CI: 2.48-29.5), whereas the incidence of concurrent chemoradiotherapy-related death was correlated with pulmonary fibrosis (OR: 22.2, CI: 5.61-87.8). Radiotherapy results were not analyzed because there were too few patients.
TRD occurred in 1.9% of the patients as a result of treatment-related lung injury in the majority of the cases.
本研究旨在评估肺癌患者治疗相关死亡（TRD）的现状。
我们使用逻辑回归分析回顾性分析了接受化疗和/或胸部放疗的肺癌患者 TRD 的发生率和危险因素。
2001 年 1 月至 2005 年 12 月期间，1225 例（222 例小细胞肺癌和 1003 例非小细胞肺癌）患者接受化疗和/或胸部放疗作为初始治疗。其中，43 例接受化疗后行胸部放疗的患者被纳入化疗组和放疗组。共有 23 例（1.9%）TRD。化疗相关死亡发生在 927 例患者中的 7 例（0.8%），包括 4 例药物性肺损伤、2 例肺炎和 1 例原因不明。同期放化疗相关死亡发生在 245 例患者中的 12 例（4.9%），包括 11 例放射性肺炎和 1 例肺炎。胸部放疗相关死亡发生在 96 例患者中的 4 例。化疗相关死亡的发生率与较差的一般状况（比值比 [OR]：11.4，95%置信区间 [CI]：3.53-37.1）、缺氧（OR：19.3，CI：6.06-61.7）、低钠血症（OR：45.5，CI：13.4-154）和表皮生长因子受体酪氨酸激酶抑制剂的使用（OR：8.56，CI：2.48-29.5）相关，而同期放化疗相关死亡的发生率与肺纤维化（OR：22.2，CI：5.61-87.8）相关。由于患者太少，未对放疗结果进行分析。
大多数情况下，治疗相关肺损伤导致 1.9%的患者发生 TRD。
