癌症治疗相关肺损伤专家共识
Expert consensus on cancer treatment-related lung injury.
作者信息
Lin Xinqing, Guo Hui, Zhao Wei, Li Min, Lin Gen, Chu Qian, Chen Enguo, Chen Liang'an, Chen Rui, Chu Tianqing, Deng Haiyi, Deng Yu, Dong Hangming, Dong Wen, Dong Yuchao, Fang Wenfeng, Gan Xin, Gong Liang, Gu Yingying, Han Qian, Hao Yue, He Yong, Hu Chengping, Hu Jie, Hu Yi, Jiang Yongliang, Jin Yang, Lan Fen, Li Weimin, Li Weifeng, Liang Wenhua, Liu Anwen, Liu Dan, Liu Ming, Liu Mengjie, Liu Zhuo, Liu Zhefeng, Luo Qun, Miao Liyun, Mu Chuanyong, Pan Pinhua, Peng Ping, Qin Jianwen, Qin Yinyin, Shen Panxiao, Shi Minhua, Song Yong, Su Chunxia, Su Jin, Su Xin, Tan Xiaowu, Tang Kejing, Tang Xiaomei, Tian Panwen, Wang Binchao, Wang Huijuan, Wang Kai, Wang Mengzhao, Wang Qi, Wang Wenxian, Wang Zhijie, Wu Di, Xu Fei, Xu Yan, Xu Chunwei, Xie Zhanhong, Xie Xiaohong, Yang Boyan, Yang Meng, Ye Feng, Ye Xiaoqun, Yu Zongyang, Zhang Jian, Zhang Jianqing, Zhang Xiaoju, Zhao Fei, Zheng Xiaobin, Zhu Bo, Zhu Zhengfei, Zhou Jianya, Zhou Jianying, Zhou Min, Zhou Qing, Zou Zihua, Kidane Biniam, Bignami Elena, Sakamaki Fumio, Roviello Giandomenico, Taniguchi Hirokazu, Jeon Kyeongman, Saric Lenko, Ariza-Prota Miguel, La-Beck Ninh M, Kanaji Nobuhiro, Watanabe Satoshi, Shukuya Takehito, Akaba Tomohiro, Leong Tracy L, Gesierich Wolfgang, Koga Yasuhiko, Tanino Yoshinori, Uehara Yuji, Li Shiyue, Chen Rongchang, Zhou Chengzhi
机构信息
State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
Department of Medical Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
出版信息
J Thorac Dis. 2025 Apr 30;17(4):1844-1875. doi: 10.21037/jtd-2025-292. Epub 2025 Apr 28.
BACKGROUND
Although advancements in cancer therapies have substantially improved the survival of cancer patients, these treatments may also result in acute or chronic lung injury. Cancer treatment-related lung injury (CTLI) presents with a diverse array of clinical manifestations and can involve multiple sites. Due to the lack of specific diagnostic protocols, CTLI can deteriorate rapidly and may be life-threatening if not promptly addressed. Unfortunately, there is no universally accepted consensus document on the diagnosis and management of CTLI.
METHODS
A multidisciplinary panel comprising experts from respiratory and critical care medicine, oncology, radiation oncology, thoracic surgery, radiology, pathology, infectious diseases, pharmacy, and rehabilitation medicine participated in this consensus development. Through a systematic literature review and detailed panel discussions, the team formulated nine key recommendations.
RESULTS
This consensus document addresses the concept, epidemiology, pathogenesis, risk factors, diagnostic approach, evaluation workflow, management strategies, differential diagnosis, type-specific management and clinical staging of CTLI. Emphasis is placed on raising awareness among clinicians and therapeutic practices through comprehensive guidelines.
CONCLUSIONS
The consensus provides a detailed diagnostic protocol for CTLI and introduces a structured management framework based on grading, typing, and staging. It highlights the critical role of multidisciplinary team (MDT) collaboration and emphasizes the need for individualized, whole-process patient care strategies to optimize clinical outcomes.
背景
尽管癌症治疗的进展显著提高了癌症患者的生存率，但这些治疗也可能导致急性或慢性肺损伤。癌症治疗相关的肺损伤（CTLI）表现出多种多样的临床表现，可累及多个部位。由于缺乏特定的诊断方案，CTLI可能迅速恶化，如果不及时处理，可能危及生命。不幸的是，关于CTLI的诊断和管理，目前尚无普遍接受的共识文件。
方法
一个由呼吸与重症医学、肿瘤学、放射肿瘤学、胸外科、放射学、病理学、传染病学、药学和康复医学专家组成的多学科小组参与了本共识的制定。通过系统的文献综述和详细的小组讨论，该团队制定了九条关键建议。
结果
本共识文件阐述了CTLI的概念、流行病学、发病机制、危险因素、诊断方法、评估流程、管理策略、鉴别诊断、类型特异性管理和临床分期。重点是通过全面的指南提高临床医生的认识和治疗实践。
结论
该共识为CTLI提供了详细的诊断方案，并引入了基于分级、分型和分期的结构化管理框架。它强调了多学科团队（MDT）协作的关键作用，并强调需要个性化、全过程的患者护理策略，以优化临床结果。
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