Open AccessLung cancer and interstitial lung disease: a literature review
Author(s) -
JeanMarc Naccache,
Q. Gibiot,
I. Monnet,
Martine Antoine,
Marie Wislez,
C. Chouaïd,
Jacques Cadranel
Publication year - 2018
Publication title -
journal of thoracic disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.682
H-Index - 60
eISSN - 2077-6624
pISSN - 2072-1439
DOI - 10.21037/jtd.2018.05.75
Subject(s) - medicine , interstitial lung disease , lung cancer , exacerbation , pathophysiology , incidence (geometry) , disease , cancer , oncology , lung , radiation therapy , gastroenterology , pathology , physics , optics
The association between lung cancer (LC) and interstitial lung disease (ILD) can be explained by the shared risk factors like smoking and physiopathology of fibrogenesis and cancerogenesis. The relative LC risk is shown to be 3.5- to 7.3-times higher in ILD, with LC occurrence estimated at 10-20% in ILD, with >15% of ILD patients likely to die from LC. ILD incidence upon LC diagnosis varied from 2.4-10.9%. Primary radiological presentations consist of peripheral lesions, mostly in the inferior pulmonary lobes, either close to or within the ILD areas. There is a trend towards inverted proportion of adenocarcinomas and squamous-cell carcinomas, with EGFR mutations very rarely found. ILD negatively impacted LC prognosis, with surgery associated with increased morbidity-mortality, particularly due to acute exacerbation (AE) of ILD. Limited resection reduced this risk, whilst increasing that of cancer mortality. Studies on radiotherapy that can induce AE-ILD are scarce. Chemotherapy was associated with similar response rates to those in LC patients without ILD, yet worse survival. This difference may be accounted for by ILD patients' poorer health and higher risk of drug-induced pneumonitis. Further studies are warranted to better understand cancer physiopathology within the fibrotic areas, along with the therapeutic strategies required.