title: Analysis of acute exacerbation of interstitial lung disease associated with chemotherapy in patients with lung cancer: A feasibility of S-1.
abstract: BACKGROUND
  Interstitial lung disease (ILD) is commonly concomitant with lung cancer, and its acute exacerbation (AE) is the most serious complication in patients receiving treatment for lung cancer.
  
  
  METHODS
  To investigate the incidence and characteristic features of AE of ILD, we conducted a retrospective study of 665 consecutive patients with lung cancer who were treated at our institute between 2008 and 2014.
  
  
  RESULTS
  Among the 665 patients, 74 (11.1%) had preexisting ILD, and 64 of them received chemotherapy. Four of the 64 patients (6.3%) had experienced AE of ILD, and two (3.1%) died of respiratory failure during first-line chemotherapy. The use of a combination of carboplatin with tegafur-gimeracil-oteracil potassium (S-1) or paclitaxel as a first-line chemotherapy for non-small cell lung cancer led to a lower frequency of AE, at 8.3% (1/12) and 9.1% (1/11), respectively. The incidence of AE rose to 12.8% (5/39) during second-line treatment, and 14 (total: 15 times) of the 64 patients (21.9%) experienced AE from the time of diagnosis to the end of treatment. The incidence of AE was 17.7% (6/34), 15.8% (3/19), 5.0% (2/40), and 4.2% (1/24) in the paclitaxel-, vinorelbine-, etoposide-, and S-1-containing regimens, respectively. No difference in clinical features and laboratory data was detected between the AE and non-AE groups.
  
  
  CONCLUSIONS
  Although this was a small retrospective study, its findings showed that S-1 and etoposide may be relatively safe options for the treatment of patients with lung cancer and concomitant ILD.
authors.affiliation: Department of Respiratory Medicine and Rheumatology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan; Department of Medical Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan. Electronic address: kakiuchi.soji@hosp.tokushima.tokushima.jp.
authors.forename: Soji
authors.initials: S
authors.lastname: Kakiuchi
authors.affiliation: Department of Respiratory Medicine and Rheumatology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan. Electronic address: mhoney@tokushima-u.ac.jp.
authors.forename: Masaki
authors.initials: M
authors.lastname: Hanibuchi
authors.affiliation: Department of Respiratory Medicine and Rheumatology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan. Electronic address: tezuka.toshifumi@tokushima-u.ac.jp.
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Tezuka
authors.affiliation: Department of Respiratory Medicine and Rheumatology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan. Electronic address: saijo@tokushima-u.ac.jp.
authors.forename: Atsuro
authors.initials: A
authors.lastname: Saijo
authors.affiliation: Department of Respiratory Medicine and Rheumatology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan. Electronic address: kenzu@tokushima-u.ac.jp.
authors.forename: Kenji
authors.initials: K
authors.lastname: Otsuka
authors.affiliation: Department of Respiratory Medicine and Rheumatology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan. Electronic address: sakaguchi.satoshi@tokushima-u.ac.jp.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Sakaguchi
authors.affiliation: Department of Respiratory Medicine and Rheumatology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan. Electronic address: yktoy@tokushima-u.ac.jp.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Toyoda
authors.affiliation: Department of Respiratory Medicine and Rheumatology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan. Electronic address: hgoto@tokushima-u.ac.jp.
authors.forename: Hisatsugu
authors.initials: H
authors.lastname: Goto
authors.affiliation: Department of Respiratory Medicine and Rheumatology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan. Electronic address: hk25@tokushima-u.ac.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawano
authors.affiliation: Department of Respiratory Medicine and Rheumatology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan. Electronic address: cbw88890@hotmail.co.jp.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Azuma
authors.affiliation: National Hospital Organization Kochi National Hospital, Kochi 780-8077, Japan. Electronic address: fogushi@kochi.hosp.go.jp.
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Ogushi
authors.affiliation: Department of Respiratory Medicine and Rheumatology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan. Electronic address: yasuhiko@tokushima-u.ac.jp.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Nishioka
mesh_terms: D000210:Acute-Phase Reaction; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018450:Disease Progression; D004338:Drug Combinations; D005047:Etoposide / Q000008:administration & dosage; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015994:Incidence; D017563:Lung Diseases, Interstitial / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D008175:Lung Neoplasms / Q000150:complications* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010094:Oxonic Acid / Q000008:administration & dosage; D017239:Paclitaxel / Q000008:administration & dosage; D012131:Respiratory Insufficiency / Q000209:etiology; D012189:Retrospective Studies; D005641:Tegafur / Q000008:administration & dosage
chemical_list: D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D005047:Etoposide; D017239:Paclitaxel
keywords: Acute exacerbation; Chemotherapy; Interstitial lung disease; Lung cancer