Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Thorac Cancer. 2023 Nov;14(33):3323-3330. doi: 10.1111/1759-7714.15124. Epub 2023 Sep 29.
Although acute exacerbation (AE) after treatment for lung cancer (LC) is a poor prognostic factor in patients with interstitial lung disease associated with lung cancer (ILD-LC), the risk of AE according to cancer treatment type remains unclear. Therefore, in the present study, we aimed to investigate the association between AE and treatment received for LC in patients with ILD-LC.
We conducted a retrospective study of patients with ILD-LC who had undergone treatment for LC between January 2018 and December 2022. The primary study outcome was the incidence of AE within 12 months of treatment for LC according to treatment type. The association between AE and all-cause mortality was evaluated as a secondary outcome.
Among a total of 137 patients, 23 (16.8%) developed AE within 12 months of treatment for LC. The incidence of AE according to treatment type was 4.3% for surgery, 16.2% for radiotherapy, 15.6% for chemotherapy, and 54.5% for concurrent chemoradiation therapy (CCRT). Patients who received CCRT were more likely to develop AE, even after adjustment for covariables (hazard ratio [HR], 15.39; 95% confidence interval [CI]: 4.00-59.19; p < 0.001). In addition, AE within 12 months of treatment for LC was associated with an increased risk of all-cause mortality (HR, 2.82; 95% CI: 1.13-7.04; p = 0.026).
Among treatment options for patients with ILD-LC, CCRT was associated with an increased risk for AE. In addition, patients with AE had a higher mortality rate than patients without AE.
尽管治疗肺癌 (LC) 后发生急性加重 (AE) 是合并肺癌相关间质性肺疾病 (ILD-LC) 患者的预后不良因素，但根据癌症治疗类型，AE 的风险尚不清楚。因此，本研究旨在探讨 ILD-LC 患者 LC 治疗后 AE 与治疗方法的关系。
我们对 2018 年 1 月至 2022 年 12 月间接受 LC 治疗的 ILD-LC 患者进行了回顾性研究。主要研究结果为 LC 治疗后 12 个月内 AE 的发生率，按治疗类型分类。AE 与全因死亡率的相关性作为次要结局进行评估。
在总共 137 例患者中，23 例（16.8%）在 LC 治疗后 12 个月内发生 AE。根据治疗类型，AE 的发生率分别为手术 4.3%、放疗 16.2%、化疗 15.6%和同步放化疗（CCRT）54.5%。接受 CCRT 的患者更易发生 AE，即使在调整协变量后（风险比 [HR]，15.39；95%置信区间 [CI]：4.00-59.19；p<0.001）。此外，LC 治疗后 12 个月内发生 AE 与全因死亡率增加相关（HR，2.82；95%CI：1.13-7.04；p=0.026）。
在 ILD-LC 患者的治疗选择中，CCRT 与 AE 风险增加相关。此外，AE 患者的死亡率高于无 AE 患者。
