Hong Yoonki, Hong Ji Young, Park Jinkyeong
Department of Internal Medicine, School of Medicine, Kangwon National University Hospital, Kangwon National University, Chuncheon, South Korea.
Department of Internal Medicine, Hanlym University Chuncheon Hospital, Chuncheon, South Korea.
Front Med (Lausanne). 2022 Feb 14;9:824266. doi: 10.3389/fmed.2022.824266. eCollection 2022.
We investigated the intensive care unit (ICU) outcomes of patients who used targeted therapy compared to those who received cytotoxic chemotherapy.
This study was based on Korean administrative health insurance claims from 2015 to 2019. We extracted data on lung cancer patients (>18 years old) who were admitted to the ICU after receiving chemotherapy.
6,930 lung cancer patients who received chemotherapy within 30 days before ICU admission were identified; the patients received cytotoxic chemotherapy (85.4%, = 5,919) and molecular targeted therapy (14.5%, = 1,011). Grade 4 neutropenia was identified only in the cytotoxic chemotherapy group (0.6%). Respiratory failure requiring ventilator treatment was more common in the cytotoxic chemotherapy group than in the targeted therapy group (HR, 3.30; 95% CI, 2.99-3.63), and renal failure requiring renal replacement therapy was not significantly different between the two groups (HR, 1.57; 95% CI, 1.36-1.80). Patients who received targeted chemotherapy stayed longer in the ICU than the cytotoxic chemotherapy. The 28-day mortality was 23.4% (HR, 0.79; 95% CI, 0.67-0.90, < 0.05) among patients who received targeted agents compared with 29.6% among patients who received cytotoxic chemotherapy.
Targeted chemotherapy for lung cancer may contribute to increasing access to critical care for lung cancer patients, which may play a role in improving critical care outcomes of lung cancer patients.
我们调查了使用靶向治疗的患者与接受细胞毒性化疗的患者在重症监护病房（ICU）的治疗结果。
本研究基于2015年至2019年韩国行政医疗保险理赔数据。我们提取了在接受化疗后入住ICU的肺癌患者（>18岁）的数据。
确定了6930例在ICU入院前30天内接受化疗的肺癌患者；这些患者接受了细胞毒性化疗（85.4%，n = 5919）和分子靶向治疗（14.5%，n = 1011）。4级中性粒细胞减少仅在细胞毒性化疗组中发现（0.6%）。需要呼吸机治疗的呼吸衰竭在细胞毒性化疗组中比靶向治疗组更常见（HR，3.30；95%CI，2.99 - 3.63），而需要肾脏替代治疗的肾衰竭在两组之间无显著差异（HR，1.57；95%CI，1.36 - 1.80）。接受靶向化疗的患者在ICU停留的时间比细胞毒性化疗的患者更长。接受靶向药物治疗的患者28天死亡率为23.4%（HR，0.79；95%CI，0.67 - 0.90，P < 0.05），而接受细胞毒性化疗的患者为29.6%。
肺癌的靶向化疗可能有助于增加肺癌患者获得重症监护的机会，这可能在改善肺癌患者的重症监护结果中发挥作用。
