Department of Respiratory Medicine, Kitasato University School of Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan.
BMC Cancer. 2019 Feb 20;19(1):163. doi: 10.1186/s12885-019-5367-0.
Small cell lung cancer (SCLC) is characterized by a high propensity for metastases and a poor prognosis irrespective of high sensitivity for initial chemotherapy. Although interstitial pneumonia (IP) is one of risk factors for lung cancer, efficacy of cytotoxic chemotherapy for patients with SCLC with IP remains unclear. Our study aims to evaluate the efficacy of systemic chemotherapy and assess risk of acute exacerbation (AE)-IP with cytotoxic drugs for extensive disease (ED)-SCLC patients with IP.
We performed a retrospective study of 192 consecutive ED-SCLC patients with IP (n = 40) and without IP (n = 152) between 2008 and 2016.
31 of 40 ED-SCLC patients with IP and 130 of 152 patients without IP received systemic chemotherapy. The efficacy of chemotherapy in patients with IP was not inferior to that in patients without IP (overall survival [OS], 7.1 [95% confidence interval (CI): 0.2-14.0] vs. 10.0 [95% CI: 8.2-11.8] months, P = 0.57). Pretreatment serum levels of lactate dehydrogenase (LDH; 651.7 ± 481.0 vs. 301.4 ± 110.7 U/mL, P = 0.01) and C-reactive protein (CRP; 8.9 ± 9.6 vs. 1.8 ± 1.8 U/mL, P = 0.008) were correlated with developed AE-IP in the ED-SCLC patients with IP.
Systemic chemotherapy was effective even in ED-SCLC patients with IP. However, the risk of developed AE-IP that was high in patients with IP and should be evaluated using serum LDH and CRP levels before initial chemotherapy.
小细胞肺癌（SCLC）具有高度转移倾向和不良预后的特点，无论初始化疗的敏感性如何。虽然间质性肺炎（IP）是肺癌的危险因素之一，但有 IP 的 SCLC 患者接受细胞毒性化疗的疗效尚不清楚。我们的研究旨在评估广泛期（ED）SCLC 合并 IP 患者全身化疗的疗效，并评估细胞毒性药物治疗合并 IP 的 ED-SCLC 患者急性加重（AE）-IP 的风险。
我们对 2008 年至 2016 年间的 192 例连续 ED-SCLC 合并 IP（n=40）和无 IP（n=152）患者进行了回顾性研究。
40 例 ED-SCLC 合并 IP 患者中有 31 例和 152 例无 IP 患者中有 130 例接受了全身化疗。合并 IP 的患者的化疗疗效并不逊于无 IP 的患者（总生存期[OS]，7.1[95%可信区间（CI）：0.2-14.0] vs. 10.0[95% CI：8.2-11.8]个月，P=0.57）。合并 IP 的 ED-SCLC 患者中，治疗前血清乳酸脱氢酶（LDH；651.7±481.0 与 301.4±110.7 U/mL，P=0.01）和 C 反应蛋白（CRP；8.9±9.6 与 1.8±1.8 U/mL，P=0.008）水平与 AE-IP 的发生相关。
即使在 ED-SCLC 合并 IP 的患者中，全身化疗也是有效的。然而，IP 患者的 AE-IP 风险较高，在开始化疗前应使用血清 LDH 和 CRP 水平进行评估。
