晚期非小细胞肺癌合并慢性阻塞性肺疾病患者的治疗对生存的影响。
Survival impact of treatment for chronic obstructive pulmonary disease in patients with advanced non-small-cell lung cancer.
机构信息
Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
出版信息
Sci Rep. 2021 Dec 8;11(1):23677. doi: 10.1038/s41598-021-03139-5.
Chronic obstructive pulmonary disease (COPD) may coexist with lung cancer, but the impact on prognosis is uncertain. Moreover, it is unclear whether pharmacological treatment for COPD improves the patient's prognosis. We retrospectively investigated patients with advanced non-small-cell lung cancer (NSCLC) who had received chemotherapy at Kyoto University Hospital. Coexisting COPD was diagnosed by spirometry, and the association between pharmacological treatment for COPD and overall survival (OS) was assessed. Of the 550 patients who underwent chemotherapy for advanced NSCLC between 2007 and 2014, 347 patients who underwent spirometry were analyzed. Coexisting COPD was revealed in 103 patients (COPD group). The median OS was shorter in the COPD group than the non-COPD group (10.6 vs. 16.8 months). Thirty-seven patients had received COPD treatment, and they had a significantly longer median OS than those without treatment (16.7 vs. 8.2 months). Multivariate Cox regression analysis confirmed the positive prognostic impact of COPD treatment. Additional validation analysis revealed similar results in patients treated with immune checkpoint inhibitors (ICIs). Coexisting COPD had a significant association with poor prognosis in advanced NSCLC patients if they did not have pharmacological treatment for COPD. Treatment for coexisting COPD has the potential to salvage the prognosis.
慢性阻塞性肺疾病（COPD）可能与肺癌共存，但对预后的影响尚不确定。此外，尚不清楚 COPD 的药物治疗是否能改善患者的预后。我们回顾性调查了在京都大学医院接受化疗的晚期非小细胞肺癌（NSCLC）患者。COPD 通过肺量测定法诊断，评估 COPD 的药物治疗与总生存期（OS）之间的关系。在 2007 年至 2014 年间接受化疗治疗晚期 NSCLC 的 550 名患者中，对 347 名接受肺量测定法的患者进行了分析。103 名患者（COPD 组）存在共存的 COPD。COPD 组的中位 OS 短于非 COPD 组（10.6 与 16.8 个月）。37 名患者接受了 COPD 治疗，他们的中位 OS 明显长于未治疗的患者（16.7 与 8.2 个月）。多变量 Cox 回归分析证实了 COPD 治疗的积极预后影响。进一步的验证分析显示，在接受免疫检查点抑制剂（ICIs）治疗的患者中也有类似的结果。对于未接受 COPD 药物治疗的晚期 NSCLC 患者，如果存在共存的 COPD，则与预后不良有显著关联。治疗共存的 COPD 有可能挽救预后。
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