TY - JOUR
T1 - Interstitial lung disease in Japanese patients with non-small cell lung cancer receiving gefitinib
T2 - An analysis of risk factors and treatment outcomes in Okayama lung cancer study group
AU - Hotta, Katsuyuki
AU - Kiura, Katsuyuki
AU - Tabata, Masahiro
AU - Harita, Shingo
AU - Gemba, Kenichi
AU - Yonei, Toshiro
AU - Bessho, Akihiro
AU - Maeda, Tadashi
AU - Moritaka, Tomonori
AU - Shibayama, Takuo
AU - Matsuo, Keisuke
AU - Kato, Katsuya
AU - Kanehiro, Arihiko
AU - Tanimoto, Yasushi
AU - Matsuo, Keitaro
AU - Ueoka, Hiroshi
AU - Tanimoto, Mitsune
PY - 2005/1/1
Y1 - 2005/1/1
N2 - Risk factors for the development of interstitial lung disease in patients with non-small cell lung cancer receiving gefitinib and the prognostic factors after interstitial lung disease development have not been established. The aim of this study was to retrospectively identify and evaluate these possible factors. PATIENTS AND METHODS We reviewed the clinical records and radiographs of 365 consecutive patients with non-small cell lung cancer who received gefitinib in West Japan between 2000 and 2003. RESULTS In total, 330 patients were eligible for interstitial lung disease evaluation, and 15 patients (4.5%) were finally confirmed to have developed interstitial lung disease by blinded expert review. Multivariate analysis revealed that pre-existing pulmonary fibrosis, poor performance status, and prior thoracic irradiation were independent risk factors for interstitial lung disease, with odds ratios of 21.0 (95% confidence interval, 5.12-86.3, P < 0.0001), 9.70 (2.27-41.4, P = 0.001), and 4.33 (1.27-14.8, P = 0.019), respectively. Among the 15 patients who developed interstitial lung disease, eight have died of the condition. Short interval from the initiation of gefitinib treatment to the onset of interstitial lung disease, acute interstitial pneumonia pattern, and the presence of pre-existing pulmonary fibrosis were associated with poor prognosis. DISCUSSION Our results suggest the importance of patient selection for gefitinib treatment based on interstitial lung disease risk factors in the Japanese population identified.
AB - Risk factors for the development of interstitial lung disease in patients with non-small cell lung cancer receiving gefitinib and the prognostic factors after interstitial lung disease development have not been established. The aim of this study was to retrospectively identify and evaluate these possible factors. PATIENTS AND METHODS We reviewed the clinical records and radiographs of 365 consecutive patients with non-small cell lung cancer who received gefitinib in West Japan between 2000 and 2003. RESULTS In total, 330 patients were eligible for interstitial lung disease evaluation, and 15 patients (4.5%) were finally confirmed to have developed interstitial lung disease by blinded expert review. Multivariate analysis revealed that pre-existing pulmonary fibrosis, poor performance status, and prior thoracic irradiation were independent risk factors for interstitial lung disease, with odds ratios of 21.0 (95% confidence interval, 5.12-86.3, P < 0.0001), 9.70 (2.27-41.4, P = 0.001), and 4.33 (1.27-14.8, P = 0.019), respectively. Among the 15 patients who developed interstitial lung disease, eight have died of the condition. Short interval from the initiation of gefitinib treatment to the onset of interstitial lung disease, acute interstitial pneumonia pattern, and the presence of pre-existing pulmonary fibrosis were associated with poor prognosis. DISCUSSION Our results suggest the importance of patient selection for gefitinib treatment based on interstitial lung disease risk factors in the Japanese population identified.
KW - Acute interstitial pneumonia
KW - Pre-existing pulmonary fibrosis
KW - Prognostic factor
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U2 - 10.1097/00130404-200509000-00010
DO - 10.1097/00130404-200509000-00010
M3 - Article
C2 - 16259873
AN - SCOPUS:28444438172
VL - 11
SP - 417
EP - 424
JO - Cancer Journal from Scientific American
JF - Cancer Journal from Scientific American
SN - 0765-7846
IS - 5
ER -