Risk factors for acute exacerbation of idiopathic interstitial pneumonia in patients undergoing lung cancer treatment

Abstract Objective Identifying risk factors for cancer treatment-related acute exacerbations (AEs) of idiopathic interstitial pneumonia (IIP) in patients with lung cancer. Methods We retrospectively reviewed clinical records of 98 patients with concurrent lung cancer and IIPs diagnosed and treated at the Sapporo Medical University Hospital from January 2010 to December 2014. Results Of the 98 patients with concurrent lung cancer and IIPs, 14 patients (14.3%) had AEs. A total of 10 patients died. The univariate analysis revealed that the patients with idiopathic pulmonary fibrosis (IPF) or usual interstitial pneumonia (UIP) patterns on chest computed tomography (CT) had significantly higher rates of AE than those with non-IPF or non-UIP patterns, respectively. Further, those with a reduced percentage of forced vital capacity (%FVC) predictive values or elevated Krebs von den Lungen-6 (KL-6) presented significantly higher rates of AE. Our multivariate analysis identified that UIP pattern on chest CT and each 10% decrease in %FVC were significant independent risk factors for AEs. Of the 14 patients who experienced AEs, 10 cases were associated with cancer treatment. The treatment-specific incidences were 3/40 (7.5%) for surgery, 5/50 (10.0%) for chemotherapy, and 2/26 (7.7%) for radiation therapy. After comparing the AE incidences in 55 cases receiving one treatment (monotherapy group) and in 29 cases receiving two types of treatment or more (multitherapy group), we found no significant differences. Conclusions Chest CT UIP patterns and reduced %FVC are independent risk factors for AE. Moreover, AE incidence did not increase in the multitherapy group compared with the monotherapy group.

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Impact of Checkpoint Inhibitor Immunotherapy, Primarily Pembrolizumab, on Infection Risk in Patients With Advanced Lung Cancer: A Comparative Retrospective Cohort Study

Clinical Infectious Diseases ◽

10.1093/cid/ciaa802 ◽

2020 ◽

Cited By ~ 1

Author(s):

Alexandre E Malek ◽

Melissa Khalil ◽

Ray Hachem ◽

Anne Marie Chaftari ◽

Johny Fares ◽

...

Keyword(s):

Risk Factors ◽

Lung Cancer ◽

Urinary Tract ◽

Cancer Treatment ◽

Cancer Patients ◽

Checkpoint Inhibitor ◽

Advanced Lung Cancer ◽

Lung Cancer Patients ◽

Independent Risk Factors ◽

Tract Infections

Abstract Background Checkpoint inhibitor (CPI) immunotherapy has revolutionized cancer treatment. However, immune-related adverse events and the risk of infections are not well studied. To assess the infectious risk of CPIs, we evaluated the incidence of infections in lung cancer patients treated with CPIs plus conventional chemotherapy (CC) vs CC alone. Methods We performed a retrospective comparative study of patients with advanced non–small cell lung cancer who received CPIs combined with CC and those treated with CC alone at our institution during January 2016 to February 2019. We compared clinical characteristics, treatments, and outcomes including infection rate and mortality between the groups. Results We identified 123 patients for the CPI group and 147 patients for the control (CC) group. Eighteen patients (15%) in the CPI group and 33 patients (22%) in the control group developed infections (P = .1). Pneumonia was the most common infection encountered in both groups. Urinary tract infection was higher in the CC group (40%) than in the CPI group (9%) (P = .01). On multivariable analysis, chronic obstructive pulmonary disease (P = .024), prior use of corticosteroids (P = .021), and neutropenia (P < .001) were independent risk factors for infection and severe infection requiring hospital admission. Chronic kidney disease (P = .02), prior cancer treatment (P = .023), and neutropenia (P < .0001) were identified as independent risk factors for all-cause mortality. Conclusions Lung cancer patients treated with CPIs combined with CC have a comparable risk of infection to those treated with CC alone, although there is a trend towards fewer infections in those given CPIs, particularly when it comes to urinary tract infections.

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Risk Factors for Postoperative Acute Exacerbation of Idiopathic Interstitial Pneumonia Following Surgery for Primary Lung Cancer

Open Journal of Respiratory Diseases ◽

10.4236/ojrd.2014.42008 ◽

2014 ◽

Vol 04 (02) ◽

pp. 48-54

Author(s):

Toru Tanaka ◽

Shinji Abe ◽

Hiroki Hayashi ◽

Koichiro Kamio ◽

Yoshinobu Saito ◽

...

Keyword(s):

Risk Factors ◽

Lung Cancer ◽

Acute Exacerbation ◽

Interstitial Pneumonia ◽

Primary Lung Cancer ◽

Idiopathic Interstitial Pneumonia

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Clinical Examination of Acute Exacerbation of Idiopathic Interstitial Pneumonia (IIP) Combined With Lung Cancer After Anti-cancer Treatment.

Haigan ◽

10.2482/haigan.41.281 ◽

2001 ◽

Vol 41 (4) ◽

pp. 281-286 ◽

Cited By ~ 16

Author(s):

Masaki Hanibuchi ◽

Toshihiko Yamaguchi ◽

Tatsuya Okada ◽

Masaru Nakagawa ◽

Soichiro Yokota ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Treatment ◽

Acute Exacerbation ◽

Interstitial Pneumonia ◽

Clinical Examination ◽

Idiopathic Interstitial Pneumonia ◽

Anti Cancer

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Chemotherapy-induced nausea and vomiting (CINV) with carboplatin plus pemetrexed or carboplatin plus paclitaxel in patients with lung cancer: a propensity score-matched analysis

BMC Cancer ◽

10.1186/s12885-021-07802-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Toshinobu Hayashi ◽

Mototsugu Shimokawa ◽

Koichi Matsuo ◽

Hirotoshi Iihara ◽

Kei Kawada ◽

...

Keyword(s):

Risk Factors ◽

Lung Cancer ◽

Propensity Score ◽

Nausea And Vomiting ◽

Lung Cancer Patients ◽

Pooled Data ◽

Female Sex ◽

Antiemetic Prophylaxis ◽

Delayed Nausea ◽

Independent Risk Factors

Abstract Background Patients with lung cancer who are treated with carboplatin-based chemotherapy regimens often experience chemotherapy-induced nausea and vomiting (CINV). However, knowledge on the effect of regimen and cofactors on the risk of CINV is limited. This study aimed to analyze and compare the incidence of CINV between lung cancer patients undergoing carboplatin plus pemetrexed (CBDCA+PEM) and those undergoing carboplatin plus paclitaxel (CBDCA+PTX) chemotherapy. Methods Pooled data of 240 patients from two prospective observational studies were compared using propensity score matching. Separate multivariate logistic regression analyses were used to identify risk factors for nausea and vomiting following chemotherapy. Results Delayed nausea was significantly more common in patients treated with CBDCA+PEM than in those treated with CBDCA+PTX (51.1% vs. 36.2%, P = 0.04), but the incidence of vomiting did not significantly differ between the two groups (23.4% vs. 14.9%, P = 0.14). The occurrence of CINV peaked on day 4 in the CBDCA+PTX group and on day 5 in the CBDCA+PEM group. Multivariate analysis showed that female sex, younger age, and CBDCA+PEM regimen were independent risk factors for delayed nausea, while female sex was an independent risk factor for delayed vomiting. Conclusions The CBDCA + PEM regimen has a higher risk of causing delayed nausea than the CBDCA + PTX regimen, and aggressive antiemetic prophylaxis should be offered to patients treated with CBDCA + PEM.

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Outcomes of Proton Therapy for Non-small Cell Lung Cancer in Patients with Interstitial Pneumonia

10.21203/rs.3.rs-861118/v1 ◽

2021 ◽

Author(s):

Shingo Hashimoto ◽

Hiromitsu Iwata ◽

Yukiko Hattori ◽

Koichiro Nakajima ◽

Kento Nomura ◽

...

Keyword(s):

Quality Of Life ◽

Lung Cancer ◽

Cancer Treatment ◽

Small Cell Lung Cancer ◽

Interstitial Pneumonia ◽

Proton Therapy ◽

Small Cell ◽

Small Cell Lung ◽

Grade 3

Abstract Background:Interstitial pneumonia (IP) is a disease with a poor prognosis. In addition, IP patients are more likely to develop lung cancer. Since IP patients frequently develop toxicities during cancer treatment, minimally invasive cancer treatment is warranted for such patients to maintain their quality of life. This study retrospectively investigated the efficacy and safety of proton therapy (PT) for non-small cell lung cancer (NSCLC) in patients with IP.Methods:Twenty-nine NSCLC patients with IP were treated with PT between September 2013 and December 2019. The patients had stage IA to IIIB primary NSCLC. Ten of the 29 patients exhibited the usual interstitial pneumonia pattern. The prescribed dose was 66-74 Grays (relative biological effectiveness) in 10-37 fractions.Results:The median follow-up period was 17.4 months (interquartile range (IQR), 9.5–32.7). The median patient age was 77 years (IQR, 71–81). The median planning target volume was 112.0 ml (IQR, 56.1–246.3). The 2-year local control, progression-free survival, and overall survival rates were 77% (95% confidence interval: 34 to 94), 31% (13–50), and 50% (26–70), respectively. According to the Common Terminology Criteria for Adverse Events (version 4.0), grade 3 acute radiation pneumonitis (RP) was observed in 1 patient. Two patients developed grade 3 late RP, but no other patients experienced serious toxicities. The patients’ quality of life (European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-LC13 and SF-36) scores had not changed after 3 months.Conclusions:PT may safely control NSCLC without adversely affecting the daily lives of IP patients.

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Monocytes as an Early Predictor for Patients with Acute Paraquat Poisoning: A Retrospective Analysis

BioMed Research International ◽

10.1155/2019/6360459 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7

Author(s):

Yong Zhao ◽

Ya Qi Song ◽

Jie Gao ◽

Shun Yi Feng ◽

Yong Li

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Receiver Operator Characteristic ◽

Monocyte Count ◽

Central Hospital ◽

Predictive Values ◽

Kaplan Meier ◽

Independent Risk Factors ◽

Early Predictor

Background. The predictive values of monocytes in the prognosis of patients with acute paraquat (PQ) poisoning are unclear. This retrospective study investigated the predictive values of monocytes in the prognosis of patients with acute PQ poisoning. Methods. Adult patients who suffered from acute PQ poisoning in the emergency care unit of Cangzhou Central Hospital from May 2012 to December 2018 were enrolled. The patients were divided into groups, namely, survival and nonsurvival, according to a 90-day prognosis. Moreover, correlation, logistic regression, receiver-operator characteristic (ROC), and Kaplan–Meier curve analyses were applied to evaluate the monocyte values used to predict the prognosis of patients with acute PQ poisoning. Result. Among the 109 patients, 45 survived within 90 days after the poisoning, resulting in a 41.28% survival rate. The monocyte count of the nonsurvivors was significantly higher than that of the survivors (P< 0.001). Correlation analysis showed that monocyte count positively correlated with plasma PQ concentration (r= 0.413; P< 0.001) and negatively correlated with survival time (r= 0.512; P< 0.001) and 90-day survival (r= 0.503; P< 0.001). Logistic regression analysis showed that elevated monocytes were the independent risk factors for the 90-day survival. The area under the ROC curve of the monocyte count used to predict the 90-day survival was 0.826 (95% CI: 0.751–0.904), the optimal cut-off was 0.51×109/L, sensitivity was 73.4%, and specificity was 86.7%. Conclusion. This study demonstrated that elevated monocyte count is a useful early predictor of 90-day survival in patients with acute PQ poisoning. However, further studies are warranted to draw firm conclusions.

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Clinical Significance of CYFRA21-1, AFP, CA-153, CEA, and CA-199 in the Diagnosis of Lung Cancer Ocular Metastasis in Hypertension Population

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.670594 ◽

2021 ◽

Vol 8 ◽

Author(s):

Jing Tang ◽

Qian-Min Ge ◽

Rong Huang ◽

Hui-Ye Shu ◽

Ting Su ◽

...

Keyword(s):

Risk Factors ◽

Lung Cancer ◽

Logistic Regression ◽

Sensitivity And Specificity ◽

Cancer Metastasis ◽

Binary Logistic Regression ◽

Diagnostic Value ◽

Ca 125 ◽

Pathological Type ◽

Independent Risk Factors

Purpose: To detect lung metastases, we conducted a retrospective study to improve patient prognosis.Methods: Hypertension patients with ocular metastases (OM group; n = 58) and without metastases (NM group; n = 1,217) were selected from individuals with lung cancer admitted to our hospital from April 2005 to October 2019. The clinical characteristics were compared by Student's t-test and chi-square test. Independent risk factors were identified by binary logistic regression, and their diagnostic value evaluated by receiver operating characteristic curve analysis.Results: Age and sex did not differ significantly between OM and NM groups; There were significant differences in pathological type and treatment. Adenocarcinoma was the main pathological type in the OM group (67.24%), while squamous cell carcinoma was the largest proportion (46.43%) in the NM group, followed by adenocarcinoma (34.10%). The OM group were treated with chemotherapy (55.17%), while the NM group received both chemotherapy (39.93%) and surgical treatment (37.06%). Significant differences were detected in the concentrations of cancer antigen (CA)−125, CA-199, CA-153, alpha fetoprotein (AFP), carcinoembryonic antigen (CEA), cytokeratin fraction 21-1 (CYFRA21-1), total prostate-specific antigen, alkaline phosphatase, and hemoglobin (Student's t-test). Binary logistic regression analysis indicated that CA-199, CA-153, AFP, CEA, and CYRFA21-1 were independent risk factors for lung cancer metastasis. AFP (98.3%) and CEA (89.3%) exhibited the highest sensitivity and specificity, respectively, while CYRFA21-1 had the highest area under the ROC curve value (0.875), with sensitivity and specificity values of 77.6 and 87.0%, respectively. Hence, CYFRA21-1 had the best diagnostic value.

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Prognostic significance of advanced lung cancer inflammation index (ALI) in multiple myeloma patients – a retrospective study

10.21203/rs.3.rs-288915/v1 ◽

2021 ◽

Author(s):

Junxia Huang ◽

Juanjuan Hu ◽

Yan Gao ◽

Fanjun Meng ◽

Tianlan Li ◽

...

Keyword(s):

Risk Factors ◽

Lung Cancer ◽

Multiple Myeloma ◽

Overall Survival ◽

Progression Free Survival ◽

Advanced Lung Cancer ◽

Free Survival ◽

Factors Influencing ◽

Independent Risk Factors ◽

Cancer Inflammation

Abstract Background: Advanced lung cancer inflammation index (ALI) is known to predict the overall survival of patients having some solid tumors or B-cell lymphoma. The study investigates the predictive value of ALI in multiple myeloma (MM) patients and the correlation between ALI and prognosis.Methods: A database of 269 MM consecutive patients who underwent chemotherapy between December 2011 and June 2019 in the Affiliated Hospital of Qingdao University was reviewed. ALI cut-off value calculated before the initial chemotherapy and post 4 courses treatment were identified according to the receiver operating characteristic (ROC) curve, and its association with clinical characteristics, treatment response, overall survival (OS), and progression-free survival (PFS) were assessed.Results: Patients in the low ALI group (n=147) had higher risk of β2 microglobulin elevation, more advanced ISS (International Classification System stage), and TP53 gene mutation, with significantly lower median overall survival (OS; 36.29 vs. 57.92 months, P = 0.010) and progression-free survival (PFS; 30.94 vs. 35.67 months, P = 0.013). Independent risk factors influencing the OS of MM patients were ALI (P = 0.007), extramedullary infiltration (P = 0.001), TP53 (P = 0.020), Plt (P = 0.005), and bone destruction (P = 0.024). ALI (P = 0.005), extramedullary infiltration (P = 0.004), TP53 (P = <0.001), Plt (P = 0.017), and complex chromosome karyotype (P = 0.010) were independent risk factors influencing the PFS of MM patients.Conclusions: ALI is a potential independent risk factor predicting the prognosis of newly diagnosed MM patients.

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