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

间质性肺病 肺癌 医学 疾病 肿瘤科 病理 内科学
作者
Yang Xu
出处
期刊:PubMed 卷期号:47 (11): 1028-1034
标识
DOI:10.3760/cma.j.cn112147-20240519-00269
摘要

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.
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