A Study On Management And Prognosis Of Interstitial Lung Disease With Lung Cancer(ILD-LC)

Background and ObjectiveInterstitial lung disease with lung cancer(ILD-LC)is rare and its management has not been fully described.This study aims to investigate the management and prognosis of ILD-LC in China.MethodsThe present analysis is a retrospective real-world data study.Clinical data of ILD-LC patients were obtained from 3 hospitals in China.The anti-cancer regimens were summarized in stages and stratifications.The overall survival(OS)of the patients,the efficacy of first-line chemotherapy and the rate of no follow-up treatment were analyzed.Univariate and multivariate analyses were performed to determine the factors affecting the OS of patients with advanced lung cancer with ILD.Results184 ILD-LC patients enrolled were biased toward male(85.3%),smoking(75.5%),idiopathic pulmonary fibrosis(IPF)(58.2%)patients with comorbidities(67.9%)and ECOG-PS score of 1(65.2%).Most patients were advanced peripheral non-small cell lung cancer.There are significant statistical differences in smoking status,comorbidities,ECOG-PS,anatomical types,ILD subtypes,lung cancer,time sequence of ILD diagnosis,anti-cancer rates and lung function rates among the three centers.The differences in smoking rates,economic,educational,and medical levels in these areas may partly explain the differences in ILD-LC characteristics.The initial anti-cancer regimens for ILD-LC are mainly chemotherapy,and patients with early-stage LC prefer surgery.In the anti-cancer cohort,the number of ILD-LC who experienced the 2nd and the 3rd or more anti-cancer regimens were 78(55.7%)and32(22.8%),respectively.In the non-anticancer cohort,the median overall survival(OS)was 3.5 months.In the early-stage cohort,the median OS was not reached in the surgery group,while 14.2 months in the systematic therapy group.In the advanced-stage cohort with systematic therapy,the median OS was 7.2 months.IIP and anti-angiogenesis were associated with OS in the univariate analysis,whereas anti-angiogenesis was an independent protective factor for advanced LC with ILD.Conclusion1.Age,ECOG-PS and lung function are the main factors that affect whether ILD-LC patients receive anti-cancer treatment.2.There are differences in the clinical characteristics of ILD-LC patients in different centers.3.Different clinical characteristics affect the choice of anti-cancer regimens and most ILD-LC patients cannot tolerate multi-stage anti-tumor therapy.4.Appropriate anti-tumor treatment can prolong the survival of ILD-LC patients.The combination of anti-angiogenic drugs can significantly improve the prognosis of advanced LC with ILD.