Department of Breast and Thyroid Surgery, Shaoxing People's Hospital (Shaoxing Hospital of Zhejiang University), Shaoxing, 312000, Zhejiang, People's Republic of China.
Cancer Chemother Pharmacol. 2020 Jan;85(1):3-7. doi: 10.1007/s00280-019-03909-z. Epub 2019 Aug 3.
In clinical practice, chemotherapy-induced interstitial pneumonitis (CIIP) is rare, but it has a high mortality. It has been reported that pegylated liposomal doxorubicin (PLD) may induce interstitial pneumonitis in some cases. However, the relationship between PLD and CIIP in breast cancer is still unknown. This study aims to investigate the incidence of PLD-induced interstitial pneumonitis in breast cancer patients.
All cases of breast cancer with chemotherapy are collected in our hospital from January 2016 to October 2018, and 354 eligible patients were included in analysis. Patients were divided into two groups according to different chemotherapy regimens received: epirubicin plus cyclophosphamide with or without docetaxel (EC/EC-T group) and PLD plus cyclophosphamide with or without docetaxel (DC/DC-T group). Patients' general information and clinical characteristics, as well as the incidence of interstitial pneumonitis were compared between the two groups.
The symptomatic interstitial pneumonitis occurred in 12 patients who received DC/DC-T treatment with an incidence of 12.25% (12/98), while no interstitial pneumonitis occurred in EC/EC-T group (p < 0.001). Of the 12 patients, 4 patients developed interstitial pneumonitis after 3 cycles of chemotherapy,7 patients after 4 cycles and 1 patient after 5 cycles. The mean interval between the beginning of chemotherapy and the onset of CIIP was 3.75 cycles.
Clinicians should pay attention to CIIP in breast cancer patients who receive more than three cycles of chemotherapy regimens containing pegylated liposomal doxorubicin plus cyclophosphamide with or without docetaxel.
在临床实践中，化疗引起的间质性肺炎（CIIP）较为罕见，但死亡率较高。有报道称多柔比星脂质体（PLD）在某些情况下可能会引起间质性肺炎。然而，PLD 与乳腺癌中的 CIIP 之间的关系尚不清楚。本研究旨在探讨 PLD 诱导的乳腺癌患者间质性肺炎的发生率。
收集我院 2016 年 1 月至 2018 年 10 月期间所有接受化疗的乳腺癌病例，共纳入 354 例符合条件的患者进行分析。根据接受的不同化疗方案将患者分为两组：表柔比星联合环磷酰胺加或不加多西紫杉醇（EC/EC-T 组）和 PLD 联合环磷酰胺加或不加多西紫杉醇（DC/DC-T 组）。比较两组患者的一般资料、临床特征及间质性肺炎的发生率。
接受 DC/DC-T 治疗的 98 例患者中有 12 例（12.25%）出现症状性间质性肺炎，而 EC/EC-T 组无间质性肺炎发生（p<0.001）。12 例间质性肺炎患者中，4 例在化疗 3 个周期后发生，7 例在化疗 4 个周期后发生，1 例在化疗 5 个周期后发生。化疗开始至 CIIP 发作的平均间隔为 3.75 个周期。
对于接受含 PLD 联合环磷酰胺加或不加多西紫杉醇的化疗方案超过 3 个周期的乳腺癌患者，临床医生应注意 CIIP 的发生。
