在广泛阶段小细胞肺癌的化疗免疫治疗后,药物诱导的间歇性肺病
Kiyoko Fukuda1, Naoko Katsurada1, Yoshitaka Kawa2
1Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan.
Heliyon
|October 12, 2023
概括
接受化疗和免疫检查点抑制剂治疗广泛阶段小细胞肺癌的患者可能会患上药物诱导的间歇性肺病 (D-ILD). 在基线CT扫描中预先存在的间歇性肺异常 (ILA) 会增加患D-ILD的风险.
科学领域:
- 在瘤学瘤学.
- 肺部病理学 肺部病理学
- 放射学 放射学是一门学科.
背景情况:
- 化疗和免疫检查点抑制剂 (化疗-ICI) 是广泛的小细胞肺癌 (ES-SCLC) 的标准.
- 间歇性肺部异常 (ILA) 是微妙的CT发现.
- 在接受化疗-ICI治疗的ES-SCLC患者中,药物诱导的间歇性肺病 (D-ILD) 发生率和ILA关联的数据有限.
研究的目的:
- 为了确定在ES-SCLC患者中D-ILD的发病率,在现实环境中用化疗-ICI治疗.
- 为了确定D-ILD发展的风险因素.
- 评估基线ILA和D-ILD发育,无进展生存期 (PFS) 和整体生存期 (OS) 之间的关联.
主要方法:
- 2019年8月至2021年11月,对70名ES-SCLC患者进行了多中心的回顾性研究,这些患者接受了化疗-ICI治疗.
- 对ILA的基线CT扫描进行分析,包括磨砂玻璃衰减 (GGA) 和网膜化.
- 在患有和没有ILA的患者之间比较D-ILD发病率,危险因素,PFS和OS.
主要成果:
- 11名患者 (15.7%) 发生了D-ILD.
- 患有D-ILD的患者在基线ILA的比例显著更高 (81.8%与33.9%,P=0.0057).
- 在患有D-ILD的患者中观察到更高的GGA和网络化频率. 两组之间没有发现PFS或OS的显著差异.
结论:
- 在化疗ICI治疗ES-SCLC患者的临床实践中,D-ILD的发生率高于临床试验中报告的.
- 在基线CT扫描中预先存在的ILA是这些患者发展D-ILD的重要风险因素.
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