Cancer Research and Treatment

Original Articles

Lung and Thoracic cancer

The Incidence and Risk Factors of Chronic Pulmonary Infection after Radiotherapy in Patients with Lung Cancer: Yeonseok Choi, Jae Myoung Noh, Sun Hye Shin, Kyungjong Lee, Sang-Won Um, Hojoong Kim, Hongryull Pyo, Yong Chan Ahn, Byeong-Ho Jeong; Cancer Res Treat. 2023;55(3):804-813. Published online January 3, 2023; DOI: https://doi.org/10.4143/crt.2022.1305

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Purpose
This study aimed to investigate cumulative incidence and risk factors associated with chronic pulmonary infection (CPI) development after radiotherapy for lung cancer.
Materials and Methods
We retrospectively analyzed 1,872 patients with lung cancer who received radiotherapy for lung cancer from 2010-2014, had a follow-up period of ≥ 3 months after radiotherapy, and did not have CPI at the time of radiotherapy. CPI was defined as pulmonary tuberculosis, non-tuberculous mycobacterial pulmonary disease, chronic pulmonary aspergillosis, or pulmonary actinomycosis. The cumulative incidence of CPI and overall survival (OS) were estimated using the Kaplan-Meier method, and a multivariable Cox proportional hazards analysis was performed to identify risk factors associated with CPI development.
Results
The median follow-up period was 2.3 years with OS rates of 55.6% and 37.6% at 2 and 5 years, respectively. CPI developed in 59 patients at a median of 1.8 years after radiotherapy, with cumulative incidence rates of 1.1%, 3.4%, 5.0%, and 6.8% at 1, 3, 5, and 7 years, respectively. A lower body mass index, interstitial lung disease, prior pulmonary tuberculosis, larger clinical target volume, history of lung cancer surgery or radiation pneumonitis, and use of inhaled corticosteroids were independent risk factors for CPI development.
Conclusion
The long-term survival rate of lung cancer patients receiving radiotherapy was not low, but the cumulative incidence of CPI gradually increased to 6.8% at 7 years after radiotherapy. Therefore, close monitoring of CPI development is required in surviving patients with risk factors.

Citations

Citations to this article as recorded by

Chronic progressive pulmonary aspergillosis within the irradiated field after stereotactic body radiotherapy: two case reports
Nao Mamuro, Noriko Kishi, Yukinori Matsuo, Masahiro Yoneyama, Hiroyuki Inoo, Minoru Inoue, Takashi Mizowaki
International Cancer Conference Journal.2025; 14(2): 113. CrossRef
Predictive nomogram for risk of pulmonary infection in lung cancer patients undergoing radiochemotherapy: development and performance evaluation
Yujie Huang
American Journal of Cancer Research.2025; 15(2): 781. CrossRef
The Inter-Relationships Among the Risk Factors for Pulmonary Infection and the Diagnostic Utility of Inflammatory Markers in Patients with Non-Small Cell Lung Cancer
Wenwen Qin, Tiebin You, Tai Guo, Ruixin Tian, Xiaoman Cui, Ping Wang
Infection and Drug Resistance.2025; Volume 18: 1111. CrossRef
Invasive aspergillosis complicated in a patient with non-small cell lung cancer harboring RET fusion during treatment with RET-TKIs: a case report and literature review
Kaidiriye Setiwalidi, Yimeng Li, Yuyan Ma, Zhanpeng Hao, Yujia Zhao, Yuxin Zhang, Xuan Liang, Tao Tian, Zhiping Ruan, Yu Yao, Xiao Fu
Frontiers in Oncology.2024;[Epub] CrossRef

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Multicenter Retrospective Analysis of Clinical Characteristics, Treatment Patterns, and Outcomes in Very Elderly Patients with Diffuse Large B-Cell Lymphoma: The Korean Cancer Study Group LY16-01: Jung Hye Choi, Tae Min Kim, Hyo Jung Kim, Sung Ae Koh, Yeung-Chul Mun, Hye Jin Kang, Yun Hwa Jung, Hyeok Shim, So Young Chong, Der-Sheng Sun, Soonil Lee, Byeong Bae Park, Jung Hye Kwon, Seung-Hyun Nam, Jun Ho Yi, Young Jin Yuh, Jong-Youl Jin, Jae Joon Han, Seok-Hyun Kim; Cancer Res Treat. 2018;50(2):590-598. Published online June 9, 2017; DOI: https://doi.org/10.4143/crt.2017.172

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Purpose
The treatment strategy for elderly patients older than 80 years with diffuse large B-cell lymphoma (DLBCL) has not been established because of poor treatment tolerability and lack of data.
Materials and Methods
This multicenter retrospective study was conducted to investigate clinical characteristics, treatment patterns and outcomes of patients older than 80 years who were diagnosed with DLBCL at 19 institutions in Korea between 2005 and 2016.
Results
A total of 194 patients were identified (median age, 83.3 years). Of these, 114 patients had an age-adjusted International Prognostic Index (aaIPI) score of 2-3 and 48 had a Charlson index score of 4 or more. R-CHOP was given in 124 cases, R-CVP in 13 cases, other chemotherapy in 17 cases, radiation alone in nine cases, and surgery alone in two cases. Twenty-nine patients did not undergo any treatment. The median number of chemotherapy cycles was three. Only 37 patients completed the planned treatment cycles. The overall response rate from 105 evaluable patientswas 90.5% (complete response, 41.9%). Twentynine patients died due to treatment-related toxicities (TRT). Thirteen patients died due to TRT after the first cycle. Median overall survival was 14.0 months. The main causes of death were disease progression (30.8%) and TRT (27.1%). In multivariate analysis, overall survival was affected by aaIPI, hypoalbuminemia, elevated creatinine, and treatment.
Conclusion
Age itself should not be a contraindication to treatment. However, since elderly patients show higher rates of TRT due to infection, careful monitoring and dose modification of chemotherapeutic agents is needed.

Citations

Citations to this article as recorded by

Treatment Patterns and Costs Among US Patients With Diffuse Large B-Cell Lymphoma not Treated With 2L Stem Cell Transplantation
Teofilia Acheampong, Tao Gu, Trong Kim Le, Scott J Keating
Future Oncology.2024; 20(10): 623. CrossRef
Identification of independent risk factors for hypoalbuminemia in patients with CKD stages 3 and 4: the construction of a nomogram
Chong-Hui Wang, Meng-Han Jiang, Ji-Min Ma, Ming-Cong Yuan, Lei Liao, Hao-Zhang Duan, Dan Wang, Lian Duan
Frontiers in Nutrition.2024;[Epub] CrossRef
TRAIL Score: A Simple Model to Predict Immunochemotherapy Tolerability in Patients With Diffuse Large B-Cell Lymphoma
Will Harris, Edward J. Bataillard, Yoonha Choi, Tarec C. El-Galaly, Vaikunth Cuchelkar, Carsten Henneges, Antonia Kwan, Daniel J. Schneider, Joseph N. Paulson, Tina G. Nielsen
JCO Clinical Cancer Informatics.2022;[Epub] CrossRef
A Multicenter Study of 239 Patients Aged Over 70 Years With Diffuse Large B-Cell Lymphoma in China
Chunli Yang, Qiaoer Li, Ke Xie, Yakun Zhang, Dania Xiang, Yunwei Han, Liqun Zou
Frontiers in Pharmacology.2022;[Epub] CrossRef
Cachexia index as a potential biomarker for cancer cachexia and a prognostic indicator in diffuse large B‐cell lymphoma
Se‐Il Go, Mi Jung Park, Sungwoo Park, Myoung Hee Kang, Hoon‐Gu Kim, Jung Hun Kang, Jung Hoon Kim, Gyeong‐Won Lee
Journal of Cachexia, Sarcopenia and Muscle.2021; 12(6): 2211. CrossRef
Treatment approaches for older and oldest patients with diffuse large B-cell lymphoma – Use of non-R-CHOP alternative therapies and impact of comorbidities on treatment choices and outcome: A Humedica database retrospective cohort analysis, 2007–2015
Vicki A. Morrison, Laurie Hamilton, Augustina Ogbonnaya, Aditya Raju, Kristin Hennenfent, Aaron Galaznik
Journal of Geriatric Oncology.2020; 11(1): 41. CrossRef
Clinical characteristics, treatment patterns and outcomes of patients older than 80 years diagnosed with DLBCL in China over a 10-year period
Zhan Shi, Xi Tang, Qianwen Shen, Jiayan Chen, Fei Liu, Xi Chen, Jingwen Wang, Jie Zhuang
Cancer Chemotherapy and Pharmacology.2019; 84(1): 127. CrossRef
Antineoplastics

Reactions Weekly.2018; 1701(1): 32. CrossRef

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Comparison of Infection between Malignant and Benign Disease: Soon Joo Wang, Jin Pok Kim; J Korean Cancer Assoc. 1994;26(2):322-330.

Abstract PDF: It is we11 known that many immunological functions such as humoral antibody, T lympho- cyte, B lymphocyte, K cell, NK cell and macrophage are decreased in patient with malignant tumor. And the differences in rate of infection, pattern and organism are expected between malignant and benign disease. So, authors examined the medical and laboratory records of 2638 patients who had under- went surgery at Seoul National University Hospital from January 1991 to December 199l and extracted 121 patients who were bacteriologically identified postaperatively excluding the patients with preoperative fever. 1) Number of patients with malignant disease was 86, with 61 males and 25 females, whose mean age was 55. 35 patients in benign disease with 18 males and 17 females, whose mean age was 42. 2) Rate of infection was 6.08% in malignant diseases, 2.85% in benign diseases, which had meaningful difference(P < 0.05). 3) Pancreatobiliary disease had the highest infection rate(15.6%) among malignant diseases and kidney allograft had the highest among benign diseases. 4) Respiratory infection(15.8%), intraabdominal abscess(13.5%) and wound infection(12.0%) were frequent in malignant diseases, but bacteremia(16.7%), wound infection(12.5%) and respiratory infection(10.4%) were frequent in benign diseases. 5) E. coli(20.8%), Coagulase(-) Staphylococccus(18.5%) and Pseduomonas(16.2%) were frequent in malignant disease, but Staphylococcus(18.6%), Enterobacter(13.6%) and Enterococcus (11.9%) were frequent in benign disease, Meaningfully frequent organisms were E. coli and Pseduomonas in malignant disease, Enterobacter in benign disease. In conclusion, infectious complications were more freguent in malignant disease than in benign disease and differences in pattern and organism of infection existed between them.

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