Clinical Characteristics and Treatment Responses of Tuberculosis Complicating Lung Cancer: A Systematic Review

Abstract

Coexistent lung cancer (LC) and pulmonary tuberculosis (TB) were sources of clinical and pathological interest and speculation for many years. Nowadays, there is compelling evidence that TB increases the risk for LC. Furthermore, active TB has been reported to complicate LC. It is well documented that lung inflammation and fibrosis could induce genetic damage, increasing the risk for LC. The patients usually have already suffered from TB when cancer was diagnosed. In such a case, the disease was confined to the upper lobes, with or without cavities, or was spread to the lymph nodes. Whereas, when TB appeared later in the course of the cancer, after anticancer chemotherapy, TB was extended and disseminated. Clinical/radiological characteristics of TB and LC resembled each other. It is extremely difficult to verify the diagnosis of active TB from clinical and/or and radiological features in LC patients. Definite diagnosis requires pathological confirmation from biopsies and microbiologic studies. TB treatment in an immune compromised host requires individualized therapeutic decisions. There are no significant differences in TB treatment responses and/or toxicity of the anti-tuberculosis medication when combined with anticancer therapy. As poor survival and high mortality rates have been reported, interactions between anti-tuberculosis and anticancer medication, affecting the efficacy of the latter, deserve further studying. KeywordsTuberculosis; Lung Cancer; Chemotherapy; Treatment