The utility of ground-glass attenuation score for anticancer treatment-related acute exacerbation of interstitial lung disease among lung cancer patients with interstitial lung disease
The utility of ground-glass attenuation score for anticancer treatment-related acute exacerbation of interstitial lung disease among lung cancer patients with interstitial lung disease
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DOI：
10.1007/s10147-019-01576-x
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发表时间：
2019-11-13
影响因子：
3.3
通讯作者：
Miyazaki, Yasunari
中科院分区：
文献类型：
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作者：
Nishiyama, Naoki;Honda, Takayuki;Miyazaki, Yasunari
背景间质性肺病（ILD）急性加重（AE）是肺癌伴ILD患者治疗中的致死性不良事件。尚未确定通过高分辨率计算机断层扫描获得的治疗前放射学结果对检测ILD抗癌治疗相关AE的价值。方法回顾性分析2例患者的临床资料。化疗队列包括2008年10月至2017年12月期间在东京医科齿科大学接受化疗的105例ILD肺癌患者。免疫检查点抑制剂（ICI）队列包括2016年1月至2018年9月期间在9家机构接受ICI治疗的48例晚期非小细胞肺癌ILD患者。AE阳性组和阴性组之间的变量进行了比较。候选变量进行多变量logistic回归分析。P值< 0.05为有统计学意义。结果化疗组和ICI组分别有12例（11.4%）和7例（14.5%）患者发生了与抗癌治疗相关的ILD AE。在多变量logistic回归分析中，磨玻璃衰减（GGA）评分是两个队列中与ILD AE发生显著相关的唯一因素（化疗和ICI队列中分别为P = 0.037和0.01）。结论GGA评分有助于预测ILD患者的抗肿瘤治疗相关不良事件。
Background Acute exacerbation (AE) of interstitial lung disease (ILD) is a fatal adverse event in the treatment of lung cancer patients with ILD. The value of pre-treatment radiological findings obtained by high-resolution computed tomography for the detection of anticancer treatment-related AE of ILD has not been established. Methods Two medical record-based retrospective studies were performed. The chemotherapy cohort included 105 lung cancer patients with ILD who received chemotherapy at Tokyo Medical and Dental University between October 2008 and December 2017. The immune checkpoint inhibitor (ICI) cohort included 48 advanced non-small cell lung cancer patients with ILD treated with ICIs at nine institutions between January 2016 and September 2018. Variables were compared between AE-positive and -negative groups. Candidate variables were analyzed by multivariate logistic regression. A P value < 0.05 was considered statistically significant. Results Anticancer treatment-related AE of ILD occurred in 12 patients (11.4%) in the chemotherapy cohort and seven patients (14.5%) in the ICI cohort. In the multivariate logistic regression analysis, ground-glass attenuation (GGA) score was the only factor significantly associated with the development of AE of ILD in both cohorts (P = 0.037 and 0.01 in the chemotherapy and ICI cohorts, respectively). Conclusion Evaluation of GGA may help predict anticancer treatment-related AE of ILD.