Interstitial lung disease associated with drug therapy
Interstitial lung disease associated with drug therapy
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DOI：
10.1038/sj.bjc.6602063
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发表时间：
2004-08-01
影响因子：
8.8
通讯作者：
Ebina, M
中科院分区：
文献类型：
--
作者：
Camus, P;Kudoh, S;Ebina, M
药物相关性间质性肺疾病(ILD)并不少见，其类型多种多样，从良性浸润性疾病到潜在致命的急性呼吸窘迫综合征。由于药物相关性ILD所致的急性呼吸衰竭具有不可预见性和快速的时间进程，因此建立诊断通常是困难的。准确的诊断是基于临床、放射学(包括高分辨率计算机断层扫描)和组织学表现，尽管通常只有通过排除才有可能。癌症化疗通常与急性疾病有关，在病理学上，这种疾病通常是弥漫性肺泡损伤。此外，联合用药加或不加放疗都会增加ILD的风险。本文综述了与ILD发展相关的非小细胞肺癌(NSCLC)的治疗方法，以及如何系统评价这些药物在ILD中的可能作用。还讨论了吉非替尼(易瑞沙)用于晚期非小细胞肺癌时，日本与世界其他地区ILD报告率的差异。然而，这种差异仍然没有得到解释，留下了重要的流行病学和机械学问题。
Drug-associated interstitial lung disease (ILD) is not uncommon, with diverse patterns ranging from benign infiltrates to the potentially fatal acute respiratory distress syndrome. As acute respiratory failure due to drug-associated ILD has an unpredictable onset and rapid time course, establishing a diagnosis is often difficult. An accurate diagnosis is based on clinical, radiological (including high-resolution computed tomography) and histological manifestations, although is often only possible by exclusion. Cancer chemotherapy is commonly associated with acute disease that, on pathology, is often diffuse alveolar damage. Furthermore, a combination of drugs with or without radiotherapy can increase the risk of ILD. This article reviews treatments for non-small-cell lung cancer (NSCLC) that are associated with the development of ILD and how systematic evaluation of the possible role of these drugs in ILD is warranted. A difference between Japan and the rest of the world in reporting rates of ILD when gefitinib ('Iressa') has been used in advanced NSCLC is also discussed. However, the difference remains unexplained, leaving important epidemiological and mechanistic questions.