Ogura Takashi, Takigawa Nagio, Tomii Keisuke, Kishi Kazuma, Inoue Yoshikazu, Ichihara Eiki, Homma Sakae, Takahashi Kazuhisa, Akamatsu Hiroaki, Ikeda Satoshi, Inase Naohiko, Iwasawa Tae, Ohe Yuichiro, Ohta Hiromitsu, Onishi Hiroshi, Okamoto Isamu, Ogawa Kazumasa, Kasahara Kazuo, Karata Hiroki, Kishimoto Takumi, Kitamura Yuka, Gemma Akihiko, Kenmotsu Hirotsugu, Sakashita Hiroyuki, Sakamoto Susumu, Sekine Katsutoshi, Takiguchi Yuichi, Tada Yuji, Toyooka Shinichi, Nakayama Yuko, Nishioka Yasuhiko, Hagiwara Koichi, Hanibuchi Masaki, Fukuoka Junya, Minegishi Yuji, Yanagihara Toyoshi, Yamamoto Nobuyuki, Yamamoto Hiromasa, Gaga Mina, Fong Kwun M, Powell Charles A, Kiura Katsuyuki
Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Japan.
Department of General Internal Medicine 4, Kawasaki Medical School, Japan.
Respir Investig. 2019 Nov;57(6):512-533. doi: 10.1016/j.resinv.2019.06.001. Epub 2019 Aug 1.
Dramatic progress in targeted therapy and immunotherapy has been changing clinical practices in lung cancer. With the accumulation of clinical practice, it has become clear that pre-existing interstitial pneumonia (IP) could be a risk factor for drug-induced lung injury, which has enhanced awareness regarding the difficulty in treating lung cancer with comorbid IP. Unfortunately, there is only low-grade evidence in the field of lung cancer with comorbid IP, because almost all clinical trials exclude such patients. There have been very few specialized clinical trials for patients with lung cancer and underlying IPs thus far. Therefore, it is necessary to treat such cases empirically or to give up on the treatment itself. Considering these circumstances, establishing how to treat lung cancer with comorbid IP is an urgent issue. This paper is a summary of the official statement reported by the Diffuse Lung Disease/Thoracic Oncology Assembly and the Japanese Respiratory Society (JRS) in 2017, which attempts to approach lung cancer with comorbid IP systematically.
靶向治疗和免疫治疗的显著进展一直在改变肺癌的临床实践。随着临床实践的积累，已经明确既往存在的间质性肺炎（IP）可能是药物性肺损伤的一个危险因素，这提高了人们对合并IP的肺癌治疗难度的认识。遗憾的是，在合并IP的肺癌领域只有低质量的证据，因为几乎所有的临床试验都排除了这类患者。迄今为止，针对合并潜在IP的肺癌患者的专门临床试验非常少。因此，有必要凭经验治疗这类病例或放弃治疗本身。考虑到这些情况，确定如何治疗合并IP的肺癌是一个紧迫的问题。本文是对弥漫性肺疾病/胸部肿瘤学大会和日本呼吸学会（JRS）在2017年报告的官方声明的总结，该声明试图系统地探讨合并IP的肺癌的治疗方法。
