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Distinctive impact of pre-existing interstitial lung disease on the risk of chemotherapy-related lung injury in patients with lung cancer

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Abstract

Purpose

Pre-existing interstitial lung disease (pre-ILD) increases the risk of chemotherapy-related lung injury (CRLI). However, whether the risk varies by type of anti-cancer cytotoxic agent in patients with pre-ILD is unknown. In this study, we hypothesized that S-1, an oral fluoropyrimidine agent, is associated with a smaller CRLI risk than docetaxel (DTX) and investigated these agents together with radiological evaluations of pre-ILD via pre-treatment chest computed tomography (CT).

Methods

After reviewing 234 and 352 patients who underwent evaluable chest CT within 6 months prior to the administration of S-1 or DTX, respectively, from January 2006 to October 2014, 60 and 89, respectively, of these patients with pre-ILD were retrospectively analysed.

Results

In total, 2 persons administered S-1 (3 %) and 16 treated with DTX (18 %) developed CRLI (p = 0.007) after the initial treatment (mean, 61 days), of whom 1 and 7, respectively, died because of respiratory failure. Pre-treatment CT revealed that 9 S-1-treated patients (16 %) and 15 DTX-treated patients (17 %) had pre-ILD occupying more than 25 % of the lung field. Multivariate analysis demonstrated that DTX administration increased the risk of CRLI by 6.47-fold versus S-1 therapy (p = 0.016). Of note, the area occupied by pre-ILD was also associated with the risk of CRLI (<25 %; odds ratio 0.309, p = 0.045).

Conclusions

Our results indicated that S-1 is associated with a smaller risk of CRLI than DTX. The area occupied by pre-ILD should also be noted when administrating anti-cancer agents.

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Authors and Affiliations

  1. Department of Respiratory Medicine, Respiratory Disease Center, Seirei Mikatahara General Hospital, 3453, Mikatahara, Kita-ku, Hamamatsu, Shizuoka, 433-8105, Japan

    Yuichi Ozawa, Daisuke Akahori, Keigo Koda, Takefumi Abe, Hirotsugu Hasegawa, Takashi Matsui & Koshi Yokomura

  2. Division of Thoracic Surgery, Respiratory Disease Center, Seirei Mikatahara General Hospital, 3453, Mikatahara, Kita-ku, Hamamatsu, Shizuoka, 433-8105, Japan

    Masayuki Tanahashi & Hiroshi Niwa

  3. Department of Radiation Oncology, Seirei Mikatahara General Hospital, 3453, Mikatahara, Kita-ku, Hamamatsu, Shizuoka, 433-8105, Japan

    Kazunari Yamada

  4. Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1, Handayama, Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan

    Takafumi Suda

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  1. Yuichi Ozawa
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  2. Daisuke Akahori
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  3. Keigo Koda
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  4. Takefumi Abe
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Correspondence to Yuichi Ozawa.

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Ozawa, Y., Akahori, D., Koda, K. et al. Distinctive impact of pre-existing interstitial lung disease on the risk of chemotherapy-related lung injury in patients with lung cancer. Cancer Chemother Pharmacol 77, 1031–1038 (2016). https://doi.org/10.1007/s00280-016-3025-7

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  • DOI: https://doi.org/10.1007/s00280-016-3025-7

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