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Asia Pac J Clin Oncol. 2019 May 20. doi: 10.1111/ajco.13175. [Epub ahead of print]

Significance of baseline computed tomography assessment for predicting the pulmonary fibrosis during the course of chemotherapy-induced pneumonitis.

Author information

1
Department of Radiology, Inje University College of Medicine, Busan Paik Hospital, Busan, Republic of Korea.
2
Department of Radiology, Dong-A University Medical Center, Busan, Republic of Korea.
3
Department of Internal Medicine, Respiratory Medicine, Inje University College of Medicine, Busan Paik Hospital, Busan, Republic of Korea.

Abstract

BACKGROUND:

The purpose of our study is to evaluate risk factors for the development of pulmonary fibrosis in the baseline computed tomography (CT) during the course of chemotherapy-induced pneumonitis (CIP).

METHODS:

We retrospectively identified 80 cases of CIP by clinical, radiological, and pathological findings. When fibrosis developed during the follow-up, the extent of pulmonary fibrosis was evaluated at final follow-up CT in terms of a 5% volumetric score for six zones. Univariate and multivariate analyses were performed to identify the clinical and radiological risk factors for the development of fibrosis and severe fibrosis over 11% in extent.

RESULTS:

Fibrosis occurred in 26 of the 80 total patients (32.5%) during a mean 5.6 months of follow up. Risk factors for developing fibrosis were revealed as preexisting interstitial lung disease (ILD) and moderate to severe emphysema in multivariate analysis (OR = 10.12, 95% CI = 2.35-43.66, and OR = 12.85, 95% CI = 2.81-58.82, respectively). Risk factors for developing severe fibrosis over 11% in extent were revealed as a moderate to severe emphysema (OR = 5.78, 95% CI = 1.07-31.26) in multivariate analysis.

CONCLUSIONS:

Moderate to severe emphysema as well as preexisting ILD visible on baseline CT are risk factors for developing pulmonary fibrosis in the course of CIP. Thin-section CT may be helpful to predict the risk of pulmonary fibrosis before administering chemotherapy.

KEYWORDS:

chemotherapy; computed tomography; drug toxicity; interstitial lung disease

PMID:
31111595
DOI:
10.1111/ajco.13175

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