Interstitial Lung Disease in Lung Cancer
Interstitial Lung Disease in Lung Cancer
复制标题
肺癌中的间质性肺疾病
作者：
S. Danson;F. Blackhall;P. Hulse;M. Ranson
肺癌通常发生在已有肺和心脏病理的个体中。这些人中的许多人既有病史，也有患职业性肺病的风险。新的和恶化的症状可能是先前存在的病理、进展性癌症或治疗的次要症状。放射治疗和常规细胞毒性化疗(如环磷酰胺、博莱霉素)引起的肺毒性，包括间质性肺疾病，多年来已被人们认识到。肺毒性也发生在较新类别的细胞毒药物中，包括脱氧胞苷类似物吉西他滨。在接受表皮生长因子受体酪氨酸激酶抑制剂吉非替尼治疗的患者中，有一小部分(0.88%)发生了间质性肺部疾病。据报道，这种并发症在日本患者中的发生率高于美国患者(分别为1.9%和0.34%)和那些既有肺纤维化的患者。本文讨论了吉非替尼相关性间质性肺疾病在认识和治疗上的困难。症状很模糊，如呼吸困难、咳嗽和发烧，很难与进行性疾病、并存的发病率和新的肺部病理相鉴别。因此，诊断是通过严格的调查来排除所有其他的鉴别诊断。目前的治疗是支持性的，包括停用吉非替尼、氧气补充、大剂量皮质类固醇和抗菌药物。
Lung cancer often develops in individuals with pre-existing pulmonary and cardiac pathology. Many of these individuals with pre-existing pathology are also at risk of occupational lung disease. New and worsening symptoms can be secondary to pre-existing pathology, progressive cancer or treatment. Pulmonary toxicity, including interstitial lung disease, following radiotherapy and conventional cytotoxic chemotherapy (e.g. cyclophosphamide, bleomycin), has been recognised for many years. Pulmonary toxicity also occurs with the newer classes of cytotoxic agents, including the deoxycytidine analogue gemcitabine. A small percentage (0.88%) of patients treated with the epidermal growth factor receptor tyrosine kinase inhibitor gefitinib have developed interstitial lung disease. This complication has been reported at a higher frequency in Japanese patients than in US patients (1.9% vs 0.34%, respectively) and in those with pre-existing pulmonary fibrosis. This review discusses the difficulties in both recognition and treatment of gefitinib-associated interstitial lung disease. Symptoms are vague, such as dyspnoea, cough and fever and can be difficult to differentiate from progressive disease, co-existing morbidity and new pulmonary pathology. Diagnosis is, therefore, by rigorous investigation to exclude all other differential diagnoses. Treatment, at present, is supportive and includes discontinuation of gefitinib, oxygen supplementation, high-dose corticosteroids and antibacterials.
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渗透性血脑屏障破坏：狗的药效学研究和恶性脑肿瘤患者的临床 I 期试验。
DOI：
--
发表时间：
1981
期刊：
Cancer treatment reports
影响因子：
--
作者：
Neuwelt,EA;Hill,SA;Frenkel,EP;Diehl,JT;Maravilla,KR;Vu,LH;Clark,WK;Rapoport,SI;Barnett,PA;Lewis,SE;Ehle,AL;BeyerJr,CW
通讯作者：
BeyerJr,CW
DOI：
10.1152/ajplung.2000.279.1.l143
发表时间：
2000-07-01
影响因子：
4.9
作者：
Wang, RQ;Ibarra-Sunga, O;Uhal, BD
通讯作者：
Uhal, BD
影响因子：
158.5
作者：
Schiller, JH;Harrington, D;Johnson, DH
通讯作者：
Johnson, DH
DOI：
10.1165/ajrcmb.11.5.7524566
发表时间：
1994-11-01
影响因子：
6.4
作者：
MADTES, DK;BUSBY, HK;CLARK, JG
通讯作者：
CLARK, JG