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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

  • Naoki Nishiyama
  • Takayuki Honda
  • Manabu Sema
  • Tatsuo Kawahara
  • Yasuto Jin
  • Ichiro Natsume
  • Tomoshige Chiaki
  • Takaaki Yamashita
  • Yoshikazu Tsukada
  • Reiko Taki
  • Yoshihiro Miyashita
  • Kazuhito Saito
  • Tomoya Tateishi
  • Hiroyuki Sakashita
  • Yasunari MiyazakiEmail author
Original Article
  • 105 Downloads

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.

Keywords

Acute exacerbation Chemotherapy HRCT score Interstitial pneumonia Immune checkpoint inhibitor 

Notes

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.

Compliance with ethical standards

Conflict of interest

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

Supplementary material

10147_2019_1576_MOESM1_ESM.docx (18 kb)
Supplementary file1 (DOCX 18 kb)
10147_2019_1576_MOESM2_ESM.pdf (7.2 mb)
Supplementary file2 (PDF 7366 kb)
10147_2019_1576_MOESM3_ESM.docx (24 kb)
Supplementary file3 (DOCX 24.1 kb)

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Copyright information

© Japan Society of Clinical Oncology 2019

Authors and Affiliations

  • Naoki Nishiyama
    • 1
  • Takayuki Honda
    • 1
  • Manabu Sema
    • 1
  • Tatsuo Kawahara
    • 1
  • Yasuto Jin
    • 2
  • Ichiro Natsume
    • 3
  • Tomoshige Chiaki
    • 4
  • Takaaki Yamashita
    • 5
  • Yoshikazu Tsukada
    • 6
  • Reiko Taki
    • 7
  • Yoshihiro Miyashita
    • 8
  • Kazuhito Saito
    • 9
  • Tomoya Tateishi
    • 1
  • Hiroyuki Sakashita
    • 1
    • 3
    • 10
  • Yasunari Miyazaki
    • 1
    Email author
  1. 1.Department of Respiratory MedicineTokyo Medical and Dental UniversityTokyoJapan
  2. 2.Department of Respiratory MedicineHiratsuka Kyosai HospitalHiratsuka-shiJapan
  3. 3.Department of Respiratory MedicineYokosuka Kyosai HospitalYokosuka-shiJapan
  4. 4.Department of Respiratory MedicineHokushin General HospitalNaganoJapan
  5. 5.Department of Respiratory MedicineJapan Agricultural Cooperatives Toride Medical CenterIbarakiJapan
  6. 6.Department of Respiratory MedicineSoka Municipal HospitalSaitamaJapan
  7. 7.Department of Respiratory MedicineJapanese Red Cross Musashino HospitalTokyoJapan
  8. 8.Department of Respiratory MedicineYamanashi Prefectural Central HospitalYamanashiJapan
  9. 9.Department of Respiratory MedicineTsuchiura Kyodo General HospitalIbarakiJapan
  10. 10.Department of ChemotherapyYokosuka Kyosai HospitalYokosuka-shiJapan

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