Analysis of acute exacerbation of interstitial lung disease associated with chemotherapy in patients with lung cancer: A feasibility of S-1

• Published in: Respiratory investigation Vol. 55; no. 2; pp. 145 - 152
• Main Authors: Kakiuchi, Soji, MD, PhD, Hanibuchi, Masaki, MD, PhD, Tezuka, Toshifumi, MD, PhD, Saijo, Atsuro, MD, Otsuka, Kenji, MD, Sakaguchi, Satoshi, MD, PhD, Toyoda, Yuko, MD, PhD, Goto, Hisatsugu, MD,PhD, Kawano, Hiroshi, MD, PhD, Azuma, Masahiko, MD, PhD, Ogushi, Fumitaka, MD, PhD, Nishioka, Yasuhiko, MD, PhD
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.03.2017
• Subjects: Acute exacerbation; Acute-Phase Reaction; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Chemotherapy; Disease Progression; Drug Combinations; Etoposide - administration & dosage; Feasibility Studies; Female; Humans; Incidence; Internal Medicine; Interstitial lung disease; Lung cancer; Lung Diseases, Interstitial - epidemiology; Lung Diseases, Interstitial - etiology; Lung Diseases, Interstitial - prevention & control; Lung Neoplasms - complications; Lung Neoplasms - drug therapy; Male; Middle Aged; Oxonic Acid - administration & dosage; Paclitaxel - administration & dosage; Pulmonary/Respiratory; Respiratory Insufficiency - etiology; Retrospective Studies; Tegafur - administration & dosage; ILD; PS; Eastern Cooperative Oncology Group; respiratory bronchiolitis-interstitial lung disease; NSIP; HR; lung cancer; interstitial lung disease; acute exacerbation; performance status; PPFE; small cell lung cancer; VNR; PFS; 95% CI; non-small cell lung cancer; pemetrexed; AE; usual interstitial pneumonia; high-resolution computed tomography; diffuse alveolar damage; desquamative interstitial pneumonia; idiopathic pulmonary fibrosis; CBDCA; idiopathic interstitial pneumonia; vinorelbine; IIP; Chemotherapy; S-1; etoposide; UIP; nanoparticle albumin-bound-paclitaxel; RB-ILD; DTX; CTD-ILD; tegafur-gimeracil-oteracil potassium; PTX; docetaxel; ECOG; connective tissue disease-interstitial lung disease; HRCT; SCLC; paclitaxel; NSCLC; DAD; progression-free survival; non-specific interstitial pneumonia; DIP; pleuroparenchymal fibroelastosis; LIP; 95% confidence interval; carboplatin; LC; lymphoid interstitial pneumonia; hazard ratio; VP-16; nab-PTX; PEM; IPF; Lung cancer; Interstitial lung disease; Acute exacerbation
• ISSN: 2212-5345; 2212-5353
• DOI: 10.1016/j.resinv.2016.10.008

Abstract Background Interstitial lung disease (ILD) is commonly concomitant with lung cancer, and its acute exacerbation (AE) is the most serious complication in patients receiving treatment for lung cancer. Methods To investigate the incidence and characteristic features of AE of ILD, we conducted a retrospective study of 665 consecutive patients with lung cancer who were treated at our institute between 2008 and 2014. Results Among the 665 patients, 74 (11.1%) had preexisting ILD, and 64 of them received chemotherapy. Four of the 64 patients (6.3%) had experienced AE of ILD, and two (3.1%) died of respiratory failure during first-line chemotherapy. The use of a combination of carboplatin with tegafur-gimeracil-oteracil potassium (S-1) or paclitaxel as a first-line chemotherapy for non-small cell lung cancer led to a lower frequency of AE, at 8.3% (1/12) and 9.1% (1/11), respectively. The incidence of AE rose to 12.8% (5/39) during second-line treatment, and 14 (total: 15 times) of the 64 patients (21.9%) experienced AE from the time of diagnosis to the end of treatment. The incidence of AE was 17.7% (6/34), 15.8% (3/19), 5.0% (2/40), and 4.2% (1/24) in the paclitaxel-, vinorelbine-, etoposide-, and S-1-containing regimens, respectively. No difference in clinical features and laboratory data was detected between the AE and non-AE groups. Conclusions Although this was a small retrospective study, its findings showed that S-1 and etoposide may be relatively safe options for the treatment of patients with lung cancer and concomitant ILD.