肺癌合并间质性肺疾病患者的治疗与预后

Treatment and Prognosis of Patients with Lung Cancer and Combined Interstitial Lung Disease.

作者信息

Mauclet Charlotte, Dupont Michaël V, Roelandt Kerwin, Regnier Maxime, Delos Monique, Pirard Lionel, Vander Borght Thierry, Dahlqvist Caroline, Froidure Antoine, Rondelet Benoît, Vanderick Jean, Remouchamps Vincent, Duplaquet Fabrice, Ocak Sebahat

机构信息

Division of Pulmonology, Clinique Saint-Luc Bouge, Rue Saint-Luc, 8, 5004 Namur, Belgium.

Division of Radiology, CHU UCL Namur (Godinne Site), Université Catholique de Louvain (UCLouvain), Avenue G. Thérasse, 1, 5530 Yvoir, Belgium.

出版信息

Cancers (Basel). 2023 Jul 30;15(15):3876. doi: 10.3390/cancers15153876.

DOI:10.3390/cancers15153876

PMID:37568692

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10417812/

Abstract

BACKGROUND

Interstitial lung disease (ILD) is associated with a higher lung cancer (LC) risk and may impact cancer's clinical characteristics, treatment strategies, and outcomes. This impact's extent is unclear, particularly in Caucasians.

METHODS

In this retrospective observational study, we reviewed the files of all LC patients diagnosed in a 38-month period. Expert radiologists reviewed the computed tomography scans performed at diagnosis. Patients with LC and ILD ( = 29, 7%) were compared to those without ILD ( = 363, 93%) for population and cancer characteristics, treatments, and clinical outcomes.

RESULTS

Patients with LC and ILD were older (73 ± 8 vs. 65 ± 11 years; < 0.001). There was no significant difference in LC histology, localization, stage, or treatment modalities. The respiratory complication rate after cancer treatment was significantly higher in the ILD group (39% vs. 6%; < 0.01). Overall survival rates were similar at 12 (52% vs. 59%; = 0.48) and 24 months (41% vs. 45%; = 0.64) but poorer in the ILD group at 36 months, although not statistically significant (9% vs. 39%; = 0.06). The ILD group had a higher probability of death (hazard ratio (HR) = 1.49 [0.96;2.27]), but this was not statistically significant ( = 0.06). In a Cox regression model, patients with ILD treated surgically had a significantly higher mortality risk (HR = 2.37 [1.1;5.09]; = 0.03).

CONCLUSIONS

Patients with combined LC and ILD have worse clinical outcomes even when similar treatment modalities are offered.

摘要

背景

间质性肺疾病（ILD）与较高的肺癌（LC）风险相关，并且可能影响癌症的临床特征、治疗策略及预后。这种影响的程度尚不清楚，尤其是在白种人中。

方法

在这项回顾性观察研究中，我们查阅了在38个月期间内确诊的所有LC患者的病历。专家放射科医生复查了诊断时进行的计算机断层扫描。将合并ILD的LC患者（n = 29，7%）与未合并ILD的患者（n = 363，93%）在人群和癌症特征、治疗及临床结局方面进行比较。

结果

合并ILD的LC患者年龄更大（73±8岁 vs. 65±11岁；P < 0.001）。在LC组织学、定位、分期或治疗方式方面无显著差异。ILD组癌症治疗后的呼吸并发症发生率显著更高（39% vs. 6%；P < 0.01）。12个月时总生存率相似（52% vs. 59%；P = 0.48），24个月时也相似（41% vs. 45%；P = 0.64），但ILD组在36个月时较差，尽管无统计学意义（9% vs. 39%；P = 0.06）。ILD组死亡概率更高（风险比（HR）= 1.49 [0.96；2.27]），但无统计学意义（P = 0.06）。在Cox回归模型中，接受手术治疗的ILD患者死亡风险显著更高（HR = 2.37 [1.1；5.09]；P = 0.0