Radiotherapy of Lung Tumours in Idiopathic Pulmonary Fibrosis

Kolek, Vı́tězslav; Vašáková, Martina; Šterclová, Martina; Cwiertka, Karel; Vrána, David; Kudláček, Aleš; Skřičková, Jana; Pešek, Miloš; Petera, Jiřı́

doi:10.14735/amko2017303

Cited by 11 publications

(9 citation statements)

References 26 publications

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“…The annual incidence of AE in patients with IPF has been reported as 5–15% [26]. Additionally, the incidence rate of AE triggered by chemotherapy [27], surgery [28], and radiotherapy [29] is increased in patients with IPF. In our study, the total incidence of AE was 15.7%.…”

Section: Discussionmentioning

confidence: 99%

Combined pulmonary fibrosis and emphysema and idiopathic pulmonary fibrosis in non-small cell lung cancer: impact on survival and acute exacerbation

et al. 2019

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Background In non-small cell lung cancer (NSCLC) patients, concomitant idiopathic pulmonary fibrosis (IPF) and emphysema (CPFE) are independently related to poor survival. CPFE is a condition with features of both pulmonary fibrosis and emphysema. Here, we evaluated the effect of CPFE and IPF alone on the outcomes of NSCLC patients. Patients and methods We retrospectively evaluated 283 patients with CPFE or IPF who were diagnosed with NSCLC between November 2003 and February 2018 at two tertiary care hospitals in South Korea. Patients were classified into CPFE and IPF groups according to chest computed tomography findings. Results One-hundred-and-seven patients (37.8%; mean age: 70.1 years; men 97.2%) had CPFE. Compared with IPF patients, CPFE patients had a heavier smoking history; lower diffusing capacity of carbon monoxide (78.0% vs 64.8%, p < 0.001), and lower forced expiratory volume in 1 s. Of all patients with NSCLC, 71.7% overall died during the follow-up period; 71.6% died in the CPFE group and 72.0% in the IPF group. Multivariate logistic regression analysis showed that CPFE (odds ratio [OR]: 2.26, 95% confidence interval [CI]: 1.09–4.69; P = 0.029) was significantly correlated with acute exacerbations (AEs). In a Cox proportional hazards analysis, stage > III NSCLC, higher Eastern Cooperative Oncology Group performance status, and higher gender–age–physiology index score was related to higher mortality. However, CPFE was not related to a higher mortality rate in univariate (hazard ratio [HR]: 1.00; 95% CI: 0.75–1.32, P = 0.972) or multivariate analysis (HR: 0.89; 95% CI: 0.66–1.21, P = 0.466). Conclusions AE risk, but not all-cause mortality, was higher in patients with CPFE and NSCLC than in those with IPF and NSCLC. Physicians should be aware of the exaggerated risk of AE in patients with concomitant CPFE and NSCLC.

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Section: Discussionmentioning

confidence: 99%

Combined pulmonary fibrosis and emphysema and idiopathic pulmonary fibrosis in non-small cell lung cancer: impact on survival and acute exacerbation

et al. 2019

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“…In palliative cases, a greater consideration should be made because of the possible further damage to the lung and, consequently, diminished quality of life. In very selected cases, external radiotherapy of small targets like, for example, main bronchi or brachytherapy, can be considered [61]. The proton beam therapy was investigated separately in patients with idiopathic pulmonary fibrosis.…”

Section: Therapeutic Optionsmentioning

confidence: 99%

Idiopathic Pulmonary Fibrosis Coexisting with Lung Cancer

Zieliński

Sitek

2018

Advances in Respiratory Medicine

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Idiopathic pulmonary fibrosis (IPF) is an interstitial lung disease with poor prognosis. Although the underlying mechanisms are not fully understood, IPF is connected with lung cancer development, which farther worsens the prognosis. Various papers report IPF and cancer coexistence in 9.8% to over 50% of patients depending on observation period. Contrary to already established guidelines in the general population, there are no widely accepted recommendations on lung cancer treatment in IPF population. At the same time, various oncologic interventions can result in acute exacerbation of IPF. In this paper authors tried to revise the available data on lung cancer in patients with preexisting IPF.

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“…It is interesting to note that one of the independent risk factors for the development of lung cancer is the diagnosis of ILD (2). However, regardless of the treatment-related toxic side effects or acutely worsened ILD patients, lung cancer complicated with ILD is a highrisk group for treatment (3)(4)(5)(6). These adverse effects can be severe, and even fatal in extreme cases.…”

Section: Introductionmentioning

confidence: 99%

Stereotactic body radiotherapy for early stage non-small cell lung cancer in patients with subclinical interstitial lung disease

Liu¹,

Zhu²,

Wu³

et al. 2020

Transl Lung Cancer Res

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Background: For lung cancer patients with subclinical (untreated and asymptomatic) interstitial lung disease (ILD), there is a lack of relatively safe and effective treatment. Stereotactic body radiation therapy (SBRT) can achieve a high level of tumor control with low toxicity in early-stage non-small cell lung cancer (NSCLC). This study aimed to evaluate the efficacy and toxicity of early stage NSCLC patients with subclinical ILD receiving SBRT.Methods: A total of 109 early stage NSCLC patients receiving SBRT treatment between December 2011 and August 2016 were reviewed in our institutions; patients with clinical ILD were excluded. The median dose of SBRT was 50 Gy in 5 fractions. The median biologically effective dose (BED; α/β=10) was 100 Gy (range, 72-119 Gy). An experienced radiation oncologist and an experienced radiologist reviewed the presence of subclinical ILD in the CT findings before SBRT. The relationships among the efficacy, radiation-induced lung injury (RILI) and subclinical ILD were explored.Results: In all, 38 (34.9%) of 109 patients were recognized with subclinical ILD before SBRT, 48 (44.0%) of 109 patients were recognized with grade 2-5 RILI after SBRT, and 18 (47.4%) of 38 patients with subclinical ILD were observed with grade 2-5 RILI. Subclinical ILD was not a significant factor of grade 2-5 RILI (P=0.608); however, 3 patients had extensive RILI, and they all suffered from subclinical ILD. Dosimetric factor of the lungs, such as mean lung dose (MLD) was significantly related with Grade 2-5 RILI in patients with subclinical ILD (P=0.042). The progression-free survival (PFS) rates at 3 years in the subclinical ILD patients and those without ILD were 61.6% and 66.8%, respectively (P=0.266).Conclusions: Subclinical ILD was not a significant factor for RILI or PFS in early stage NSCLC patients receiving SBRT; however, patients with subclinical ILD receiving SBRT may experience uncommon extensive RILI.

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Radiotherapy of Lung Tumours in Idiopathic Pulmonary Fibrosis

Cited by 11 publications

References 26 publications

Combined pulmonary fibrosis and emphysema and idiopathic pulmonary fibrosis in non-small cell lung cancer: impact on survival and acute exacerbation

Combined pulmonary fibrosis and emphysema and idiopathic pulmonary fibrosis in non-small cell lung cancer: impact on survival and acute exacerbation

Idiopathic Pulmonary Fibrosis Coexisting with Lung Cancer

Stereotactic body radiotherapy for early stage non-small cell lung cancer in patients with subclinical interstitial lung disease

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