Clinical significance of chronic pulmonary aspergillosis in lung cancer patients undergoing anticancer drug therapy.

IF 2.3 3区医学 Q3 ONCOLOGY Thoracic Cancer Pub Date : 2024-09-01 Epub Date: 2024-08-01 DOI:10.1111/1759-7714.15416

Kenji Morimoto, Ryosuke Hamashima, Tadaaki Yamada, Toshihide Yokoyama, Takehiko Kobayashi, Kazunari Tsuyuguchi, Takanori Kanematsu, Nobuyo Tamiya, Taisuke Tsuji, Ryota Nakamura, Yuki Katayama, Naoya Nishioka, Masahiro Iwasaku, Shinsaku Tokuda, Koichi Takayama

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Abstract

Background: Advances in anticancer drugs for lung cancer (LC) have improved the prognosis of LC. Chronic pulmonary aspergillosis (CPA) is a progressive and often exacerbating respiratory disease with a poor prognosis. To date, the prognosis of LC complicated by CPA has not been elucidated. This study investigated the clinical implications of concomitant CPA in patients with LC undergoing anticancer drug treatment.

Methods: Between January 2010 and May 2020, we consecutively enrolled patients with LC complicated with CPA at five different institutions in Japan. We analyzed patients with LC complicated by CPA who received anticancer drug treatment.

Results: A total of 10 patients with LC complicated by CPA received anticancer drug treatment. The median overall survival (OS) was 14.57 months (95% confidence interval [CI]: 5.37-21.67). The cause of death in all patients was LC. Six of the seven patients with LC did not show worsening pulmonary aspergillosis lesions during the anticancer drug treatment. Although two patients discontinued anticancer drug treatment due to pneumonitis, CPA complications did not interfere with the continuation of anticancer drug treatment. In univariate analyses, squamous histology (p = 0.01) and body mass index (<18.5 kg/m²) (p = 0.0008) were significantly associated with poorer OS.

Conclusions: This study demonstrated that the cause of death in LC patients with concomitant CPA who received anticancer drug treatments and effective antifungal treatment was LC progression. Further large-scale studies are needed to identify the effect of CPA in patients with LC.

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接受抗癌药物治疗的肺癌患者慢性肺曲霉菌病的临床意义。

背景：肺癌抗癌药物的进步改善了肺癌的预后。慢性肺曲霉菌病（CPA）是一种进展性且经常恶化的呼吸系统疾病，预后较差。迄今为止，并发 CPA 的 LC 的预后尚未明确。本研究探讨了接受抗癌药物治疗的 LC 患者并发 CPA 的临床影响：方法：2010 年 1 月至 2020 年 5 月期间，我们在日本 5 家不同机构连续招募了并发 CPA 的 LC 患者。我们对接受抗癌药物治疗的并发 CPA 的 LC 患者进行了分析：共有 10 名并发 CPA 的 LC 患者接受了抗癌药物治疗。中位总生存期（OS）为 14.57 个月（95% 置信区间 [CI]：5.37-21.67）。所有患者的死因均为 LC。七名 LC 患者中有六名在抗癌药物治疗期间没有出现肺曲霉病变恶化。虽然有两名患者因肺炎中断了抗癌药物治疗，但 CPA 并发症并未影响抗癌药物治疗的继续。在单变量分析中，鳞状组织学（p = 0.01）和体重指数（2）（p = 0.0008）与较差的OS显著相关：本研究表明，在接受抗癌药物治疗和有效抗真菌治疗的同时伴有CPA的LC患者中，死亡原因是LC进展。需要进一步开展大规模研究，以确定 CPA 对 LC 患者的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Thoracic Cancer ONCOLOGY-RESPIRATORY SYSTEM

CiteScore

5.20

自引率

3.40%

发文量

439

审稿时长

2 months

期刊介绍： Thoracic Cancer aims to facilitate international collaboration and exchange of comprehensive and cutting-edge information on basic, translational, and applied clinical research in lung cancer, esophageal cancer, mediastinal cancer, breast cancer and other thoracic malignancies. Prevention, treatment and research relevant to Asia-Pacific is a focus area, but submissions from all regions are welcomed. The editors encourage contributions relevant to prevention, general thoracic surgery, medical oncology, radiology, radiation medicine, pathology, basic cancer research, as well as epidemiological and translational studies in thoracic cancer. Thoracic Cancer is the official publication of the Chinese Society of Lung Cancer, International Chinese Society of Thoracic Surgery and is endorsed by the Korean Association for the Study of Lung Cancer and the Hong Kong Cancer Therapy Society. The Journal publishes a range of article types including: Editorials, Invited Reviews, Mini Reviews, Original Articles, Clinical Guidelines, Technological Notes, Imaging in thoracic cancer, Meeting Reports, Case Reports, Letters to the Editor, Commentaries, and Brief Reports.