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肺癌与间质性肺疾病

Lung Cancer and Interstitial Lung Diseases.

作者信息

Drakopanagiotakis Fotios, Krauss Ekaterina, Michailidou Ira, Drosos Vasileios, Anevlavis Stavros, Günther Andreas, Steiropoulos Paschalis

机构信息

Department of Pneumonology, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece.

European IPF Registry & Biobank (eurIPFreg/Bank), 35394 Giessen, Germany.

出版信息

Cancers (Basel). 2024 Aug 13;16(16):2837. doi: 10.3390/cancers16162837.

Abstract

Lung cancer continues to be one of the leading causes of cancer-related death worldwide. There is evidence of a complex interplay between lung cancer and interstitial lung disease (ILD), affecting disease progression, management strategies, and patient outcomes. Both conditions develop as the result of common risk factors such as smoking, environmental exposures, and genetic predispositions. The presence of ILD poses diagnostic and therapeutic challenges in lung cancer management, including difficulties in interpreting radiological findings and increased susceptibility to treatment-related toxicities, such as acute exacerbation of ILD after surgery and pneumonitis after radiation therapy and immunotherapy. Moreover, due to the lack of large, phase III randomized controlled trials, the evidence-based therapeutic options for patients with ILDs and lung cancer remain limited. Antifibrotic treatment may help prevent pulmonary toxicity due to lung cancer treatment, but its effect is still unclear. Emerging diagnostic modalities and biomarkers and optimizing personalized treatment strategies are essential to improve outcomes in this patient population.

摘要

肺癌仍然是全球癌症相关死亡的主要原因之一。有证据表明肺癌与间质性肺疾病(ILD)之间存在复杂的相互作用,影响疾病进展、管理策略和患者预后。这两种疾病都是由吸烟、环境暴露和遗传易感性等共同风险因素导致的。ILD的存在给肺癌管理带来了诊断和治疗挑战,包括解读放射学检查结果的困难以及对治疗相关毒性的易感性增加,如术后ILD急性加重、放疗和免疫治疗后肺炎。此外,由于缺乏大型III期随机对照试验,针对ILD合并肺癌患者的循证治疗选择仍然有限。抗纤维化治疗可能有助于预防肺癌治疗引起的肺部毒性,但其效果仍不明确。新兴的诊断方法和生物标志物以及优化个性化治疗策略对于改善该患者群体的预后至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c623/11352559/86c2b75a3ca4/cancers-16-02837-g001.jpg

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