Interstitial lung disease in Japanese patients with non-small cell lung cancer receiving gefitinib: An analysis of risk factors and treatment outcomes in Okayama lung cancer study group
Interstitial lung disease in Japanese patients with non-small cell lung cancer receiving gefitinib: An analysis of risk factors and treatment outcomes in Okayama lung cancer study group
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DOI：
10.1097/00130404-200509000-00010
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发表时间：
2005-09-01
期刊：
影响因子：
2.2
通讯作者：
Tanimoto, M
中科院分区：
文献类型：
--
作者：
Hotta, K;Kiura, K;Tanimoto, M
接受吉非替尼治疗的非小细胞肺癌患者发生间质性肺病的风险因素和间质性肺病发生后的预后因素尚未确定。患者和方法我们回顾了2000年至2003年在西日本接受吉非替尼治疗的365例非小细胞肺癌患者的临床记录和X线照片。结果总共有330例患者符合间质性肺疾病评估的条件，15例（4.5%）经盲法专家评审最终确诊为间质性肺病。多变量分析显示，肺纤维化、体力状态差和既往胸部放疗是间质性肺病的独立危险因素，优势比为21.0（95%可信区间，5.12-86.3，P < 0.0001）、9.70（2.27-41.4，P = 0.001）和4.33（1.27-14.8，P = 0.019）。在15名患间质性肺病的患者中，有8人死于这种疾病。从吉非替尼治疗的开始到间质性肺病，急性间质性肺炎的模式，和预先存在的肺纤维化的存在的短时间间隔与预后不良。讨论我们的研究结果表明，在日本人群中确定的间质性肺病的危险因素的基础上，吉非替尼治疗的患者选择的重要性。
Risk factors for the development of interstitial lung disease in patients with non-small cell lung cancer receiving gefitinib and the prognostic factors after interstitial lung disease development have not been established. The aim of this study was to retrospectively identify and evaluate these possible factors.PATIENTS AND METHODS We reviewed the clinical records and radiographs of 365 consecutive patients with non-small cell lung cancer who received gefitinib in West Japan between 2000 and 2003.RESULTS In total, 330 patients were eligible for interstitial lung disease evaluation, and 15 patients (4.5%) were finally confirmed to have developed interstitial lung disease by blinded expert review. Multivariate analysis revealed that preexisting pulmonary fibrosis, poor performance status, and prior thoracic irradiation were independent risk factors for interstitial lung disease, with odds ratios of 21.0 (95% confidence interval, 5.12-86.3, P < 0.0001), 9.70 (2.27-41.4, P = 0.001), and 4.33 (1.27-14.8, P = 0.019), respectively. Among the 15 patients who developed interstitial lung disease, eight have died of the condition. Short interval from the initiation of gefitinib treatment to the onset of interstitial lung disease, acute interstitial pneumonia pattern, and the presence of pre-existing pulmonary fibrosis were associated with poor prognosis.DISCUSSION Our results suggest the importance of patient selection for gefitinib treatment based on interstitial lung disease risk factors in the Japanese population identified.