1538P - Acute Exacerbation of Pre-Existing Interstitial Lung Disease (ILD) in Patients (PTS) with Lung Cancer Under Various Treatments

Abstract

ABSTRACT Background Acute deterioration of ILD for unknown causes, sometimes called as acute exacerbation (AE), can occur at any point in the course of ILD. However, little is known about its incidence and prognostic significance in lung cancer pts with pre-existing ILD, who receive various treatments; chemotherapy, surgery, palliative radiotherapy, and best supportive care (BSC). Methods A total of 242 subjects (6.9% of all) were retrospectively identified to have pre-existing ILD by computed tomography (CT) from a sum of 3524 pts who had been hospitalized for lung cancer treatment at 8 institutions during 2004 to 2009. CT images of all the eligible pts were centrally reviewed. Univariate and multivariate analyses were performed using a Cox proportional hazard model to examine the potential role of any prognostic factors for overall survival (OS) from the initial lung cancer diagnosis. Results Pts' characteristics were: male/female = 217/25; median age (range) = 73 (42-98) yrs.; smoking status: ever/never = 223/19; Performance Status: 0/1/2/3/4 = 74/121/23/19/5; Stage I/II/III/IV = 48/10/98/86; Histology: adeno/squamous/large/NOS/small = 90/75/6/19/52; CT pattern: usual interstitial pneumonia (UIP)/non-UIP = 118/124; extent of normal lung on baseline CT: 10-50%/60-90% = 154/88; pre-existing emphysema: yes/no = 178/64. AE occurred in 71 of 242 pts (29%) overall; 56 of 147 pts (38%) with chemotherapy, 6 of 38 pts (16%) with surgery, 2 of 17 pts (12%) with palliative radiotherapy, and 5 of 36 pts (14%) with BSC alone, and chemotherapy was an independent risk factor for the occurrence of AE (P Conclusions The occurrence of AE is not rare in the lung cancer treatment, particularly during chemotherapy, and it is a factor for poor prognosis in pts with pre-existing ILD. Disclosure All authors have declared no conflicts of interest.