Wang Yanning, Miao Liyun, Hu Yuxuan, Zhou Yujie
Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital, Nanjing, China.
School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China.
Front Oncol. 2020 Sep 8;10:1636. doi: 10.3389/fonc.2020.01636. eCollection 2020.
Lung cancer is a well-known comorbidity of interstitial lung disease (ILD), and the actual efficacy and safety of chemotherapy for patients with non-small cell lung cancer and interstitial lung disease (NSCLC-ILD) have not been determined. We conducted this meta-analysis to assess the efficacy and safety of chemotherapy for patients with NSCLC-ILD. We searched related studies from the Cochrane Library, PubMed, and Embase. The endpoints were objective response rate (ORR), disease control rate (DCR), 1-year overall survival rate (1-yOS rate), and first-line chemotherapy-related acute exacerbation of interstitial lung disease rate (AE-ILD rate). We included 21 studies involving 684 patients in our analysis. The pooled ORR was 43% (95% CI: 38.0-49.0%), and the pooled DCR was 80.0% (95% CI: 75.7-83.9%). The modified overall 1-yOS rate was 33.0% (95% CI: 29.0-37.0%). The pooled AE-ILD rate was 8.07% (95% CI: 6.12-10.26%). Subgroup analysis revealed a trend for lower AE-ILD rate (4.98%; 95% CI: 2.44-8.37%) in patients with carboplatin plus nab-paclitaxel. Lung function and AE-ILD may be associated with the prognosis of patients with NSCLC-ILD. First-line chemotherapy is effective in patients with NSCLC-ILD, and the AE-ILD rate is acceptable, but the prognosis is limited. Future randomized controlled trials are needed to explore more appropriate treatment regimens to improve the prognosis of patients with NSCLC-ILD.
肺癌是间质性肺疾病（ILD）的一种常见合并症，非小细胞肺癌合并间质性肺疾病（NSCLC-ILD）患者化疗的实际疗效和安全性尚未确定。我们进行了这项荟萃分析，以评估NSCLC-ILD患者化疗的疗效和安全性。我们检索了Cochrane图书馆、PubMed和Embase中的相关研究。终点指标为客观缓解率（ORR）、疾病控制率（DCR）、1年总生存率（1-yOS率）和一线化疗相关的间质性肺疾病急性加重率（AE-ILD率）。我们的分析纳入了21项研究，涉及684例患者。汇总的ORR为43%（95%CI：38.0-49.0%），汇总的DCR为80.0%（95%CI：75.7-83.9%）。修正后的总体1-yOS率为33.0%（95%CI：29.0-37.0%）。汇总的AE-ILD率为8.07%（95%CI：6.12-10.26%）。亚组分析显示，接受卡铂联合白蛋白结合型紫杉醇治疗的患者AE-ILD率有降低趋势（4.98%；95%CI：2.44-8.37%）。肺功能和AE-ILD可能与NSCLC-ILD患者预后相关。一线化疗对NSCLC-ILD患者有效，AE-ILD率可接受，但预后有限。未来需要进行随机对照试验，以探索更合适的治疗方案，改善NSCLC-ILD患者的预后。
