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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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Abstract

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.

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Acknowledgements

The authors would like to thank Y Sakakibara, Y Wakai, Y Watanabe, T Tsutsui, T Yagi, S Yamashita, and M Doi for cooperation in collecting data. We also thank T Mitsumura and R Sakakibara for useful comments and suggestions.

Author information

Author notes

  1. Naoki Nishiyama and Takayuki Honda contributted equally.

Authors and Affiliations

  1. Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan

    Naoki Nishiyama, Takayuki Honda, Manabu Sema, Tatsuo Kawahara, Tomoya Tateishi, Hiroyuki Sakashita & Yasunari Miyazaki

  2. Department of Respiratory Medicine, Hiratsuka Kyosai Hospital, 9-11 Oiwake, Hiratsuka-shi, Kanagawa, 254-8502, Japan

    Yasuto Jin

  3. Department of Respiratory Medicine, Yokosuka Kyosai Hospital, 1-16 Yonegahama-dori, Yokosuka-shi, Kanagawa, 238-8558, Japan

    Ichiro Natsume & Hiroyuki Sakashita

  4. Department of Respiratory Medicine, Hokushin General Hospital, 1-5-63 Nishi, Nakano-shi, Nagano, 383-8505, Japan

    Tomoshige Chiaki

  5. Department of Respiratory Medicine, Japan Agricultural Cooperatives Toride Medical Center, 2-1-1 Hongo, Toride-shi, Ibaraki, 302-0022, Japan

    Takaaki Yamashita

  6. Department of Respiratory Medicine, Soka Municipal Hospital, 2-21-1 Soka, Soka-shi, Saitama, 340-8560, Japan

    Yoshikazu Tsukada

  7. Department of Respiratory Medicine, Japanese Red Cross Musashino Hospital, 1-26-1 Kyonancho, Musashino-shi, Tokyo, 180-8610, Japan

    Reiko Taki

  8. Department of Respiratory Medicine, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu-shi, Yamanashi, 400-8506, Japan

    Yoshihiro Miyashita

  9. Department of Respiratory Medicine, Tsuchiura Kyodo General Hospital, 4-1-1 Otsuno, Tsuchiura-shi, Ibaraki, 300-0028, Japan

    Kazuhito Saito

  10. Department of Chemotherapy, Yokosuka Kyosai Hospital, 1-16 Yonegahama-dori, Yokosuka-shi, Kanagawa, 238-8558, Japan

    Hiroyuki Sakashita

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  1. Naoki Nishiyama
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  2. Takayuki Honda
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Correspondence to Yasunari Miyazaki.

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Yasunari Miyazaki received lecture fees from Nippon Boehringer Ingelheim Co., Ltd.

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Nishiyama, N., Honda, T., Sema, M. et al. 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. Int J Clin Oncol 25, 282–291 (2020). https://doi.org/10.1007/s10147-019-01576-x

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