Author of

• 16722

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  P1.04 - Poster Session with Presenters Present (ID 456)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Pulmonology
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 16748

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    P1.04-026 - Coexisting Lung Cancer and Interstitial Lung Disease: A Challenge in Clinical Practice (ID 5611)

    14:30 - 14:30  |  Author(s): S. Campainha
    • Abstract

    Background:
    Lung cancer (LC) risk is increased in patients with interstitial lung disease (ILD), and the two diseases sometimes occur concomitantly. Cigarette smoking is a recognised risk factor for development of both pathologies but the aetiology and pathogenesis of LC in patients with ILD is still unclear. The benefit of chemotherapy or radiotherapy for LC in cases of ILD remains unknown. Objective: To analyse characteristics and outcomes of patients with ILD and LC.
    
    Methods:
    A retrospective analysis of all patients presenting with concomitant ILD and lung cancer to our centre, between 1[st] January 2011 and 30[th] June 2016, was performed. Diagnosed lung cancer patients with suspected ILD, but not confirmed, were excluded, as well as patients who developed ILD in the setting of lung cancer therapy. Clinical, radiological and pathological characteristics of this cohort were described. Outcomes were also reported.
    
    Results:
    Eleven patients were included (mean age 63±12years). Most patients were men (82%) and heavy smokers (64% had a smoking history >30pack/year). The majority ILD cases were related to connective tissue disease (45%) and combined pulmonary fibrosis and emphysema (CPFE) (18%). The most prevalent lung cancer histological type was adenocarcinoma (45%); most patients were diagnosed at advanced stages (63%) and mainly during the clinical and radiological follow-up for the fibrosis. The mean time from the onset of ILD to the onset of LC was 39.4 months. On chest CT, the tumours were predominantly peripheral. Surgical resection was performed in 3 patients with stage I or II LC; chemotherapy and/or radiotherapy were given to 6 patients with advanced disease (stage III and IV). One patient was refused for radiotherapy due to considerations of the adverse effects on the prognosis. The median survival since the diagnosis of LC was 6.7months. Two patients died of respiratory failure due to progression of pneumonitis after the therapy and three patients died due to progression of LC.
    
    Conclusion:
    Patients with LC and ILD might benefit from chemotherapy and radiotherapy, but pre-existing ILD could influence negatively the prognosis. Therapy for LC should be considered in patients presenting both LC and ILD and interdisciplinary evaluation of therapeutic options is mandatory. When planning radiotherapy it is important determinate the radiation pneumonitis risk. More studies are needed to clarify the role of LC treatment in the management of ILD patients.