Jo Hyunji, Park Sojung, Kim Nam Eun, Park So Young, Ryu Yon Ju, Chang Jung Hyun, Lee Jin Hwa
Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul 07804, Korea.
J Clin Med. 2022 Apr 24;11(9):2391. doi: 10.3390/jcm11092391.
Chronic obstructive pulmonary disease (COPD) is associated with a poor prognosis in patients with non-small cell lung cancer (NSCLC). However, the impact of COPD treatment on the survival of patients with advanced NSCLC remains uncertain. We retrospectively investigated COPD patients among patients newly diagnosed with advanced NSCLC between September 2005 and August 2019 at a university hospital. The clinical characteristics, lung function, and survival outcomes were analyzed and compared between patients who did and did not receive COPD treatment. Among 221 patients with advanced NSCLC and COPD, 124 patients received treatment for COPD and 97 patients did not receive treatment for COPD. Forced expiratory volume in 1 s (FEV1) % predicted value was greater in the no-treatment group than in the COPD treatment group (p < 0.001). The median overall survival (OS) of the treatment group was 10.7 months, while that of the no-treatment group was 8.7 months (p = 0.007). In the multivariate analysis, COPD treatment was independently associated with improved OS (hazard ratio 0.71, 95% confidence interval 0.53−0.95, and p = 0.021). COPD treatment was associated with improved OS in patients with advanced NSCLC and COPD. Therefore, pretreatment spirometry and maximal treatment for COPD may offer a chance of optimal management for patients with advanced NSCLC.
慢性阻塞性肺疾病(COPD)与非小细胞肺癌(NSCLC)患者的预后不良相关。然而,COPD治疗对晚期NSCLC患者生存的影响仍不确定。我们回顾性调查了2005年9月至2019年8月在一家大学医院新诊断为晚期NSCLC的患者中的COPD患者。分析并比较了接受和未接受COPD治疗的患者的临床特征、肺功能和生存结果。在221例晚期NSCLC合并COPD的患者中,124例接受了COPD治疗,97例未接受COPD治疗。未治疗组的1秒用力呼气量(FEV1)预测值百分比高于COPD治疗组(p<0.001)。治疗组的中位总生存期(OS)为10.7个月,而未治疗组为8.7个月(p = 0.007)。在多变量分析中,COPD治疗与OS改善独立相关(风险比0.71,95%置信区间0.53−0.95,p = 0.021)。COPD治疗与晚期NSCLC合并COPD患者的OS改善相关。因此,治疗前肺活量测定和COPD的最大治疗可能为晚期NSCLC患者提供最佳管理的机会。