Effect of platinum-based chemotherapy for non-small cell lung cancer patients with interstitial lung disease.

Abstract

The prognosis of non-small cell lung cancer (NSCLC) patients with interstitial lung disease (ILD) is unclear. To assess the prognosis of NSCLC patients with ILD treated with platinum-based chemotherapy, we retrospectively analyzed the clinical course of those with ILD. One hundred and four NSCLC patients with ILD treated with platinum-based chemotherapy at Shizuoka Cancer Center between August 2002 and June 2013 were retrospectively reviewed. The combination of carboplatin with paclitaxel was most frequently used as the first-line treatment for NSCLC patients with ILD (61%). The overall response rate was 38% in 104 NSCLC patients with ILD treated with platinum-based chemotherapy. In all patients, median progression-free survival and overall survival were 4.8 and 9.9months, respectively. During first-line platinum-based chemotherapy, 9% of the 104 patients with ILD developed chemotherapy-related exacerbation of ILD. Multivariate analysis demonstrated that clinical stage was a significantly independent prognostic factor (hazard ratio 0.517; 95% confidence interval 0.314-0.842, p=0.0079). Patients with clinical stage IV or recurrence after surgical resection showed poor prognosis (median survival time 8.5months). Our study suggests that the prognosis of NSCLC patients with ILD is poor. The risk of exacerbation of ILD in patients treated with platinum-based chemotherapy as the first-line treatment was slightly lower than in previous reports.