Department of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan.
Department of Thoracic Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.
Ther Adv Respir Dis. 2020 Jan-Dec;14:1753466620963866. doi: 10.1177/1753466620963866.
The clinical features of patients with small cell lung cancer (SCLC) and idiopathic pulmonary fibrosis (IPF) have not been fully elucidated.
Data on 366 patients with pathologically confirmed SCLC who had been treated with chemotherapy or chemoradiotherapy were retrospectively analyzed to investigate the clinical features of SCLC with IPF.
A total of 97 out of the 366 patients were diagnosed with interstitial lung disease (ILD), and 75 of them had IPF. For both the limited disease (LD) and extensive disease (ED) stages, the median progression-free survival (PFS) and overall survival (OS) were significantly shorter in the patients with IPF compared with non-ILD patients. A multivariate analysis showed that poor performance status, ED stage, and the presence of IPF were associated with shorter OS. The response rate to first-line therapy was significantly lower in patients with IPF compared with the non-ILD patients. The rate of patients receiving fewer than three cycles of first-line chemotherapy was higher in patients with IPF, which was a factor of poor survival. In LD-stage patients with IPF, chemoradiotherapy was associated with longer PFS and OS compared with chemotherapy only.
In patients with SCLC, the presence of IPF was associated with a lower response rate as well as shorter PFS and shorter OS. There are some cases that are suitable for chemoradiotherapy, even among patients with IPF.
小细胞肺癌（SCLC）和特发性肺纤维化（IPF）患者的临床特征尚未完全阐明。
回顾性分析了 366 例经病理证实的 SCLC 患者的资料，这些患者接受了化疗或放化疗，以研究伴有 IPF 的 SCLC 的临床特征。
在 366 例患者中，共有 97 例被诊断为间质性肺疾病（ILD），其中 75 例为 IPF。对于局限性疾病（LD）和广泛性疾病（ED）阶段，与非ILD 患者相比，IPF 患者的无进展生存期（PFS）和总生存期（OS）明显更短。多变量分析显示，较差的体力状态、ED 期和存在 IPF 与较短的 OS 相关。与非ILD 患者相比，IPF 患者对一线治疗的反应率明显较低。IPF 患者接受的一线化疗周期少于 3 个的比例较高，这是生存不良的一个因素。在 LD 期伴 IPF 的患者中，与单纯化疗相比，放化疗可延长 PFS 和 OS。
在 SCLC 患者中，存在 IPF 与较低的反应率以及较短的 PFS 和 OS 相关。在伴有 IPF 的患者中，存在一些适合放化疗的情况。
