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[不同抗肿瘤方案对肺癌患者新型冠状病毒肺炎发生率和严重程度的影响:一项单中心回顾性研究]

[Effect of Different Antitumor Regimens on Incidence and Severity of Corona Virus 
Disease 2019 Pneumonia in Lung Cancer Patients: 
A Single-center Retrospective Study].

作者信息

Lu Wanjun, Lv Jiawen, Wang Qin, Yao Yanwen, Wang Dong, Chen Jiayan, Wu Guannan, Gu Xiaoling, Li Huijuan, Chen Yajuan, Han Hedong, Lv Tangfeng, Song Yong, Zhan Ping

机构信息

Department of Respiratory and Critical Care, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210002, China.

Department of Respiratory and Critical Care, General Hospital of Eastern Theater Command, People's Liberation Army of China, Nanjing 210002, China.

出版信息

Zhongguo Fei Ai Za Zhi. 2023 Jun 20;26(6):429-438. doi: 10.3779/j.issn.1009-3419.2023.102.20.

Abstract

BACKGROUND

Studies have shown that the incidence and severity of corona virus disease 2019 (COVID-19) in patients with lung cancer are higher than those in healthy people. At present, the main anti-tumor treatments for lung cancer include surgery, immunotherapy, chemotherapy, radiotherapy, targeted therapy and anti-angiogenesis therapy. While the effects of different anti-tumor treatments on the occurrence and severity of COVID-19 pneumonia are not uniform. Therefore, we aimed to describe clinical characteristics and antitumor therapy of patients with lung cancer and COVID-19 pneumonia, and examined risk factors for severity in this population.

METHODS

From December 1, 2022 to February 15, 2023, a retrospective study was conducted in 217 patients diagnosed with COVID-19 and pathologically confirmed lung cancer in the Jinling Hospital. We collected data about patients' clinical features, antitumor treatment regimen within 6 months, and the diagnosis and treatment of COVID-19. Risk factors for occurrence and severity of COVID-19 pneumonia were identified by univariable and multivariable Logistic regression models.

RESULTS

(1) Among the 217 patients included, 51 (23.5%) developed COVID-19 pneumonia, of which 42 (82.4%) were classified as medium and 9 (17.6%) were classified as severe; (2) Univariate and multivariate analysis revealed overweight (OR=2.405, 95%CI: 1.095-5.286) and intrapulmonary focal radiotherapy (OR=2.977, 95%CI: 1.071-8.274) are risk factors for increasing occurrence of COVID-19 pneumonia, while other therapies are not; (3) Chronic obstructive pulmonary disease (COPD) history (OR=7.600, 95%CI: 1.430-40.387) was more likely to develop severe pneumonia and anti-tumor therapies such as intrapulmonary focal radiotherapy, chemotherapy, targeted therapy and immunotherapy did not increase severity.

CONCLUSIONS

Intrapulmonary focal radiation therapy within 6 months increased the incidence of COVID-19 pneumonia, but did not increase the severity. However, there was no safety concern for chemotherapy, targeted therapy, surgery and immunotherapy.

摘要

背景

研究表明,肺癌患者感染2019冠状病毒病(COVID-19)的发生率和严重程度高于健康人。目前,肺癌的主要抗肿瘤治疗方法包括手术、免疫治疗、化疗、放疗、靶向治疗和抗血管生成治疗。不同的抗肿瘤治疗对COVID-19肺炎的发生和严重程度的影响并不一致。因此,我们旨在描述肺癌合并COVID-19肺炎患者的临床特征和抗肿瘤治疗情况,并研究该人群病情严重程度的危险因素。

方法

2022年12月1日至2023年2月15日,对金陵医院217例确诊为COVID-19且经病理证实为肺癌的患者进行了一项回顾性研究。我们收集了患者的临床特征、6个月内的抗肿瘤治疗方案以及COVID-19的诊断和治疗数据。通过单变量和多变量Logistic回归模型确定COVID-19肺炎发生和严重程度的危险因素。

结果

(1)在纳入的217例患者中,51例(23.5%)发生了COVID-19肺炎,其中42例(82.4%)为中度,9例(17.6%)为重度;(2)单因素和多因素分析显示,超重(OR=2.405,95%CI:1.095-5.286)和肺内局部放疗(OR=2.977,95%CI:1.071-8.274)是COVID-19肺炎发生率增加的危险因素,而其他治疗方法则不是;(3)慢性阻塞性肺疾病(COPD)病史(OR=7.600,95%CI:1.430-40.387)更易发生重症肺炎,而肺内局部放疗、化疗、靶向治疗和免疫治疗等抗肿瘤治疗并未增加重症程度。

结论

6个月内的肺内局部放疗增加了COVID-19肺炎的发生率,但未增加重症程度。然而,化疗、靶向治疗、手术和免疫治疗不存在安全性问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1a0/10365958/2c62313631e9/img_1.jpg

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