Significance of baseline CT assessment for predicting the pulmonary fibrosis during the course of chemotherapy-induced pneumonitis

Congress:

ESTI 2019

Poster Number:

P-0055

Type:

Scientific Poster

Keywords:

Drugs / Reactions, Cancer, Complications, Chemotherapy, CT, Thorax, Lung

Authors:

J.-Y. Han, J. W. Baek, K.-N. Lee, S. J. Choi; Busan/KR

DOI:

10.26044/esti2019/P-0055

DOI-Link:

https://dx.doi.org/10.26044/esti2019/P-0055

Fig. 1: Diagram of the patient selection process.

Table 1: Characteristics of 80 Cases with CIP

Table 2: Summary of chemotherapeutic agents used in 26 patients with fibrosis

Purpose

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

Methods & Materials

Patient characteristics Patient selection and exclusion are demonstrated in Figure 1. Reviewed demographics, underlying malignancies, chemotherapeutic agent, exposure duration, preexisting ILD and past history of CIP CT Analysis Brilliance iCT (Philips) / 2mm thickness without a gap CIP was categorized into 4 patterns: Usual interstitial pneumonia (UIP), probable UIP, indeterminate for UIP and non UIP in accordance with the ATS/ERS/JRS/LATAS Statement Extent of fibrosis ; on axial scan individually in terms of a 5% volumetric score for 6 zones (Figure 2) Radiologic risk factors lung...

Results

The clinical characteristics and chemotherapy type of 80 patients are conveyed in Tables 1. Frequent agents associated with CIP were everolimus (30.4%, 7/23) among the molecularly targeted agents, and cisplatin (25.8%, 16/62) among the cytotoxic agents. Fibrosis occurred in 26 cases (32.5%, 26/80) among patients with CIP. The average of extent of fibrosis at the last follow-up CT was 15.98% Interobserver and intraobserver variability (0.933 and 0.960, respectively) Fibrosis extent according to chemotherapeutic agents is summarized inTable2. Compared the data of patients who developed fibrosis...

Conclusion

Summary In this study, we described the factors for the development of pulmonary fibrosis in the baseline CT during the course of CIP. Our study showed that CT findings of fibrosis remained in 32.5% of the patients with CIP. Preexisting ILD and moderate to severe emphysema were significant risk factors for developing fibrosis in CIP. Moderate to severe emphysema was a significant risk factor for developing severe fibrosis over 11% in extent in our study. Limitation Diagnosis of the pattern of ILD was based on...

References

Dimopoulou, I., et al., Pulmonary toxicity from novel antineoplastic agents. Ann Oncol, 2006. 17(3): p. 372-9. Vahid, B. and P.E. Marik, Pulmonary complications of novel antineoplastic agents for solid tumors. Chest, 2008. 133(2): p. 528-38 Sakurada, T., et al., Characteristics of and risk factors for interstitial lung disease induced by chemotherapy for lung cancer. Ann Pharmacother, 2015. 49(4): p. 398-404. Akira, M., H. Ishikawa, and S. Yamamoto, Drug-induced pneumonitis: thin-section CT findings in 60 patients. Radiology, 2002. 224(3): p. 852-60. Lee, H.N., et al., Thin-Section...