title: Characteristics of and risk factors for interstitial lung disease induced by chemotherapy for lung cancer.
abstract: BACKGROUND
  Drug-induced interstitial lung disease (DILD) is generally a serious adverse effect and almost always necessitates the discontinuation of the offending drug. Cancer pharmacotherapy is strongly associated with DILD, and the risk of DILD has been suggested to be higher in patients with lung cancer because of preexisting pneumonic disease.
  
  
  OBJECTIVE
  The aim of this retrospective study was to identify the risk factors and prognostic factors for early death from interstitial lung disease (ILD) induced by chemotherapy for lung cancer.
  
  
  METHODS
  The medical records of 459 patients who underwent chemotherapy for lung cancer between April 2007 and March 2013 were analyzed with regard to patient background and DILD development, initial symptoms, and prognosis.
  
  
  RESULTS
  A total of 33 patients (7.2%) developed chemotherapy-induced ILD. The most frequently observed initial symptom was dyspnea (94.3%). Preexisting ILD was identified as a risk factor for DILD (odds ratio [OR] = 5.38; 95% CI = 2.47-11.73; P < 0.01). Among the 33 patients who developed DILD, 10 patients suffered an early death despite steroid therapy. Poor prognostic factors included epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) use (OR = 9.26; 95% CI = 1.05-82.0; P < 0.05) and 2 or more prior chemotherapy regimens (OR = 6.95; 95% CI = 1.14-42.3; P < 0.05).
  
  
  CONCLUSIONS
  Many lung cancer patients have coexisting ILD, and these patients have a high risk of developing chemotherapy-induced ILD. In addition, patients with DILD who underwent EGFR-TKI therapy and 2 or more prior chemotherapy regimens had a higher risk of fatal outcome.
authors.affiliation: Department of Pharmacy, Tokushima University Hospital, Tokushima, Japan sakurada@tokushima-u.ac.jp.
authors.forename: Takumi
authors.initials: T
authors.lastname: Sakurada
authors.affiliation: Department of Medical Oncology, Institute of Health Biosciences, University of Tokushima Graduate School, Japan Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, University of Tokushima Graduate School, Japan.
authors.forename: Soji
authors.initials: S
authors.lastname: Kakiuchi
authors.affiliation: Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Tajima
authors.affiliation: Department of Pharmacy, Tokushima University Hospital, Tokushima, Japan.
authors.forename: Yuya
authors.initials: Y
authors.lastname: Horinouchi
authors.affiliation: Department of Pharmacy, Tokushima University Hospital, Tokushima, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Okada
authors.affiliation: Department of Pharmacy, Tokushima University Hospital, Tokushima, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Nishisako
authors.affiliation: Department of Pharmacy, Tokushima University Hospital, Tokushima, Japan.
authors.forename: Toshimi
authors.initials: T
authors.lastname: Nakamura
authors.affiliation: Department of Pharmacy, Tokushima University Hospital, Tokushima, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Teraoka
authors.affiliation: Department of Pharmacy, Tokushima University Hospital, Tokushima, Japan Department of Clinical Pharmacy, Institute of Health Biosciences, University of Tokushima Graduate School, Japan.
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Kawazoe
authors.affiliation: Clinical Trial Center for Developmental Therapeutics, Tokushima University Hospital, Tokushima, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Yanagawa
authors.affiliation: Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, University of Tokushima Graduate School, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Nishioka
authors.affiliation: Department of Pharmacy, Tokushima University Hospital, Tokushima, Japan Department of Clinical Pharmacy, Institute of Health Biosciences, University of Tokushima Graduate School, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Minakuchi
authors.affiliation: Department of Pharmacy, Tokushima University Hospital, Tokushima, Japan Department of Clinical Pharmacy, Institute of Health Biosciences, University of Tokushima Graduate School, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Ishizawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000139:chemically induced* / Q000209:etiology; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000970:Antineoplastic Agents
keywords: chemotherapy; drug-induced interstitial lung disease; lung cancer; poor prognosis factors; risk factors