[Clinical diagnosis and treatment of lung cancer combined with interstitial lung disease].

Publisher: Chinese Medical Association Country of Publication: China NLM ID: 8712226 Publication Model: Print Cited Medium: Print ISSN: 1001-0939 (Print) Linking ISSN: 10010939 NLM ISO Abbreviation: Zhonghua Jie He He Hu Xi Za Zhi Subsets: MEDLINE

Publication: Beijing : Chinese Medical Association
Original Publication: Beijing : Zhonghua yi xue hui, 1987-

Lung Diseases, Interstitial*/therapy ; Lung Diseases, Interstitial*/diagnosis ; Lung Diseases, Interstitial*/etiology ; Lung Diseases, Interstitial*/complications ; Lung Neoplasms*/therapy ; Lung Neoplasms*/diagnosis ; Lung Neoplasms*/complications; Humans ; Prognosis ; Risk Factors ; Comorbidity

Lung cancer and interstitial lung disease have similar risk factors and pathogenesis. The incidence of lung cancer associated with interstitial lung disease is increasing, and the problem of comorbidity has gradually attracted attention. Early diagnosis of lung cancer associated with interstitial lung disease is difficult, there are many factors influencing treatment, and the prognosis is poor. Interstitial lung disease affects the treatment options for lung cancer in comorbid patients, and lung cancer treatment will increase the risk of acute exacerbation of interstitial lung disease in comorbid patients. For patients with early-stage lung cancer complicated with interstitial lung disease who have surgical indications, the surgical method and extend of resection should be determined on the basis of MDT according to tumor stage and lung function. For patients with early-stage lung cancer combined with interstitial lung disease who are not suitable for surgery, the benefits and risks of complications of the radiotherapy should be weighed, and the appropriate radiotherapy regimen and dose should be selected. Chemotherapy is an effective treatment for patients with advanced lung cancer complicated with interstitial lung disease. Some chemotherapy regimens cause acute progression of interstitial lung disease, and the choice of chemotherapy regimen is particularly important. For lung cancer patients with interstitial lung disease who are positive for driver gene mutations, targeted drugs with low pulmonary toxicity should be selected. Patients with lung cancer combined with interstitial lung disease may benefit from immunotherapy, but the risk of immune-related pneumonia is increased. The occurrence of adverse reactions should be closely monitored during immunotherapy. In the future, more prospective clinical trials are needed to formulate reasonable and effective treatment regimens for lung cancer combined with interstitial lung disease to achieve a better prognosis.

Local Abstract: [Publisher, Chinese] 肺癌与间质性肺疾病（ILD）有相似的危险因素与发病机制，肺癌合并间质性肺疾病的发病率及患病率增高，二者共病问题已逐渐引起临床重视。肺癌与ILD共病早期诊断困难，治疗影响因素多，病死率高，患者预后差。肺癌与ILD共病可能影响患者肺癌治疗方案的选择，同时肺癌的治疗措施也会增加共病患者ILD急性进展的风险。早期肺癌与ILD共病患者若有手术指征，应根据肿瘤分期及肺功能，在MDT基础上决定手术方式及切除范围；若不适合手术，应权衡放疗获益及并发症发生风险，选择合适放疗方案及剂量。化疗是晚期肺癌与ILD共病患者有效的治疗方案，但部分化疗方案可能导致ILD急性进展，因此化疗方案的选择尤为重要。对于驱动基因突变阳性的肺癌与ILD共病患者，应选用肺毒性低的靶向药物。肺癌与ILD共病患者可以从免疫治疗中获益，但免疫相关肺炎的发生风险增高，免疫治疗中需要密切监测不良反应的发生。未来需要开展前瞻性临床试验，制定对于肺癌与ILD共病患者安全有效的治疗方案，使其获得更好的疗效及预后。.

Date Created: 20241105 Date Completed: 20241105 Latest Revision: 20241105

20241105

10.3760/cma.j.cn112147-20240519-00269

39497386