Background
Methods
Patient selection
Treatment method
Evaluation of response and toxicity
Statistical method
Results
Patient characteristics
IIPs | Non-ILD | ||||
---|---|---|---|---|---|
UIP + non- UIP IIPs | UIP | Non-UIP IIPs | |||
Number of patients | 25 | 12 | 13 | 88 | |
Age (year)
| Median (range) | 69 (58–81) | 71 (58–80) | 68 (60–81) | 70 (35–92) |
Gender
| Male (%) | 23 (92.0) | 12 (100) | 11 (84.6) | 41 (46.6) |
Smoking History
| Yes (%) | 24 (96.0) | 12 (100) | 12 (92.3) | 49 (55.7) |
Performance status
| 0-1 (%) | 21 (84.0) | 10 (83.3) | 11 6) | 80 (92.0) |
Histology
| Adenocarcinoma (%) | 22 (88.0) | 10 (83.3) | 12 (92.3) | 83 (94.3) |
Stage
| IIIB + IV (%) | 19 (76.0) | 10 (83.3) | 9 (69.2) | 73 (82.9) |
Line
| 1/2/3 | 5/10/10 | 2/4/6 | 3/6/4 | 13/44/31 |
EGFR mutation
| Sensitive (%) | 3 (12.0) | 1 (8.3) | 2 (15.3) | 28 (31.8) |
Efficacy and survival
Toxicity
IIPs | non-ILD | ||||
---|---|---|---|---|---|
Number of patients | 25 | 88 |
P
| ||
n | % | n | % | ||
AST, ALT
| 1 | 4 | 2 | 2.2 |
0.45
|
Eruption
| 4 | 16 | 4 | 4.4 |
0.13
|
Nausea
| 1 | 4 | 3 | 3.4 |
0.63
|
Allergic fever
| 0 | 0 | 4 | 4.4 |
0.63
|
Neutropenia
| 3 | 12 | 14 | 15.9 |
0.85
|
Leukocytopenia
| 2 | 8 | 7 | 8 |
0.68
|
Anemia
| 0 | 0 | 2 | 2.2 |
0.92
|
Thorombocytopenia
| 0 | 0 | 1 | 1.1 |
0.50
|
Febrile neutrocytopenia
| 0 | 0 | 1 | 1.1 |
0.50
|
Pulmonary toxicity
IIPs | Non-IIPs | Total | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
UIP + non- UIP IIPs | UIP | Non-UIP IIPs | ||||||||
n | % | n | % | n | % | n | % | N | % | |
Number of Patients
| 25 | 12 | 13 | 88 | 113 | |||||
Pulmonary toxicity
| 3 | 12 | 2 | 16.7 | 1 | 7.7 | 1 | 1.1 | 4 | 3.5 |
Grade 5 ILD
| 3 | 2 | 1 | 0 | 3 |
Number of patients | ||||||
---|---|---|---|---|---|---|
Overall | Pulmonary toxicity | non-Pulmonary toxicity | Odds ratio | 95% CI |
P
| |
Number of patients
| 113 | 4 | 109 | |||
Age (year)
| 0.36 | 0.03-3.62 |
0.62
| |||
<71
| 60 | 3 | 57 | |||
≧71
| 53 | 1 | 52 | |||
Gender
| 2.36 | 0.23-23.41 |
0.63
| |||
Female
| 49 | 1 | 48 | |||
Male
| 64 | 3 | 61 | |||
Smoking history
| 1.80 | 0.18-17.9 |
1.00
| |||
No
| 42 | 1 | 41 | |||
Yes
| 71 | 3 | 68 | |||
Performance status
| 0.34 | 0.28-31.0 |
0.37
| |||
0-1
| 101 | 3 | 98 | |||
2-3
| 11 | 1 | 10 | |||
Number of line
| 0.57 | 0.05-5.71 |
1.00
| |||
1-2
| 72 | 3 | 69 | |||
3-
| 41 | 1 | 40 | |||
IIPs
| 11.8 | 1.17-119.6 |
0.03*
| |||
No
| 88 | 1 | 87 | |||
Yes
| 25 | 3 | 22 |
Odds ratio | 95% CI |
P
| |
---|---|---|---|
Variable | |||
Age (<71 vs ≧71)
| 0.20 | 0.003-2.52 |
0.23
|
Gender (Female vs Male)
| 1.32 | 0.03-53.99 |
0.86
|
Smoking history (no vs yes)
| 4.68 | 0.09-443.12 |
0.44
|
Performance status (0–1 vs 2–3)
| 0.17 | 0.005-5.38 |
0.28
|
Number of line (1–2 vs 3-)
| 0.23 | 0.009-2.83 |
0.27
|
IIPs (no vs yes)
| 34.37 | 1.64-4566.21 |
0.019*
|
Discussion
A/G | Before PEM CT findings | Histology | Post RTx | Pre Chemotherapy | Combination therapy | No. of cycle | Treatment | Outcome | Reference | |
---|---|---|---|---|---|---|---|---|---|---|
1 | 65/M | UIP | MPM | No | None | CBDCA | 1 | Steroid Pulse | Dead | [17] S Sakamoto et al |
2 | 66/F | None | NSCLC (Ad) | No | CDDP + VNR | CDDP | 4 | Steroid (oral) | Recover | [19] HO Kim. et al |
3 | 71/M | None | MPM | No | None | CDDP | 1 | Steroid Pulse | Dead | [18] K Nagata. et al |
4 | 77/M | None | MPM | No | None | CBDCA | 1 | Steroid Pulse | Dead | [18] K Nagata. et al |
5 | 72/F | None | NSCLC (Ad) | No | CBDCA + PEM | CBDCA | 2 | Steroid (oral) | Recover | [20] B Dhakal. et al |
6 | 64/M | RTx-P | NSCLC (Ad) | Yes | CBDCA + VP-16 | None | 2 | Steroid Pulse | Dead | [21] A Hochstrasser. et al |
7 | 51/M | RTx-P | NSCLC (Ad) | Yes | CDDP + DTX | None | 2 | Steroid Pulse | Recover | [21] A Hochstrasser. et al. 2012 |
8 | 69/M | None | NSCLC (Ad) | No | CBDCA + GEM | None | 1 | Steroid Pulse | Recover | [22] KH Kim et al |
1 | 64/M | UIP | NSCLC (Ad) | No | CBDCA + PTX + BEV | None | 2 | Steroid Pulse | Dead | Our case |
2 | 71/M | UIP | NSCLC (Ad) | No | None | None | 1 | Steroid Pulse | Recover | Our case |
3 | 68/M | GGO | NSCLC (Ad) | No | CBDCA + PTX | None | 2 | Steroid Pulse | Dead | Our case |
4 | 67/F | None | NSCLC (Ad) | No | CBDCA + PTX, DTX, Gefitinib, | None | 3 | Drug withdrawn | Recover | Our case |