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化疗患者中药物性肺疾病的发病率及临床特征

Incidence and Clinical Characteristics of Drug-Induced Lung Disease Among Chemotherapy Recipients.

作者信息

Cörüt Ruhsel, Altundağ Ozden, Eyüboğlu Füsun

机构信息

Pulmonology, Giresun University Faculty of Medicine, Giresun, TUR.

Medical Oncology, Faculty of Medicine, Başkent University, Ankara, TUR.

出版信息

Cureus. 2024 Jun 28;16(6):e63408. doi: 10.7759/cureus.63408. eCollection 2024 Jun.

Abstract

Background Chemotherapeutic agents treat cancer and some inflammatory diseases due to their immunosuppressive effects. While effective, these drugs can cause drug-induced lung disease (DILD), a serious adverse effect with limited data regarding its incidence and clinical presentation. Methods This retrospective study included 20 patients diagnosed with DILD out of 1,231 patients treated with chemotherapeutic agents who presented with symptoms such as cough, fever, dyspnea, and chest pain at an oncology outpatient clinic. Patients underwent assessments including clinical examination, chest radiography, high-resolution computed tomography, and, in some cases, video-assisted thoracoscopic surgery. A statistical analysis was performed to determine the incidence and evaluate the clinical characteristics of DILD. Results The incidence of DILD among patients treated with chemotherapeutic agents was 0.27%. The female/male ratio was 11/9, with a mean age of 53.2 years. Common symptoms included cough (70%), dyspnea (60%), fever (50%), and sputum production (40%). Imaging revealed pleural effusion, reticular patterns, and consolidation in varying proportions. Common agents causing pulmonary toxicity included bleomycin, cyclophosphamide, and methotrexate, among others. Importantly, 95% of patients showed improvement with steroid treatment, although statistical significance was not achieved (p > 0.05). Conclusion The findings highlight the need for heightened awareness and monitoring of DILD in patients receiving chemotherapeutic treatments. Early diagnosis and prompt treatment initiation are crucial to managing this potentially severe complication. This study underscores the importance of considering pulmonary risks when prescribing chemotherapeutic agents and provides foundational data for future research.

摘要

背景 化疗药物因其免疫抑制作用可用于治疗癌症和一些炎症性疾病。虽然这些药物有效,但可导致药物性肺病(DILD),这是一种严重的不良反应,关于其发病率和临床表现的数据有限。方法 这项回顾性研究纳入了1231例接受化疗药物治疗的患者中被诊断为DILD的20例患者,这些患者在肿瘤门诊出现咳嗽、发热、呼吸困难和胸痛等症状。患者接受了包括临床检查、胸部X线摄影、高分辨率计算机断层扫描,以及在某些情况下的电视辅助胸腔镜手术等评估。进行了统计分析以确定DILD的发病率并评估其临床特征。结果 接受化疗药物治疗的患者中DILD的发病率为0.27%。女性/男性比例为11/9,平均年龄为53.2岁。常见症状包括咳嗽(70%)、呼吸困难(60%)、发热(50%)和咳痰(40%)。影像学检查发现不同比例的胸腔积液、网状影和实变影。引起肺毒性的常见药物包括博来霉素、环磷酰胺和甲氨蝶呤等。重要的是,95%的患者接受类固醇治疗后有所改善,尽管未达到统计学显著性(p>0.05)。结论 研究结果强调了对接受化疗治疗的患者提高对DILD的认识和监测的必要性。早期诊断和及时开始治疗对于管理这种潜在的严重并发症至关重要。本研究强调了在开具化疗药物时考虑肺部风险的重要性,并为未来研究提供了基础数据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19d8/11283914/f0af5537da4a/cureus-0016-00000063408-i01.jpg

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