Acute Exacerbation of Idiopathic Pulmonary Fibrosis with Lung Cancer: A Comparative Analysis of the Incidence, Survival Rate, and CT Findings with the Patients without Lung Cancer

서지정보

· 발행기관 : 대한영상의학회
· 수록지 정보 : 대한영상의학회지 / 81권 / 3호 / 688 ~ 700페이지
· 저자명 : 조범상, 강희, 김제훈, 박정구, 박세경, 윤종혁

초록

Purpose To compare the incidence, survival rate, and CT findings of acute exacerbation (AE) of idiopathic pulmonary fibrosis (IPF) between patients with and without lung cancer.
Materials and Methods From June 2004 to July 2018, 89 consecutive patients diagnosed with IPF were included. Among them, 26 patients had IPF with lung cancer (IPF-LCA), and 63 patients had IPF alone. The clinical characteristics and CT findings associated with IPF, lung cancer, and AE were reviewed. Surgery and chemotherapy were performed for 6 and 23 cases of lung cancer, respectively, as the first- or second-line anticancer treatment. The overall survival, CT findings, disease-free period before AE, and duration from the onset of AE to death were compared.
Results The incidence of AE was 61.5% in the IPF-LCA group and 58.7% in the IPF group (p = 0.806).
The mean overall survival in the IPF-LCA and IPF groups were 16.8 and 83.0 months, respectively (p < 0.001). The mean durations from the start of the lung cancer treatment to the onset of AE were 16.0 and 4.6 months in cases of surgical treatment and chemotherapy, respectively. In comparison of death from AE, the survival rate was significantly lower in the IPF-LCA group than in the IPF group (p = 0.008). In the CT findings associated with AE, the IPF-LCA group tended to have a peribronchial (p < 0.001) or asymmetric distribution (p = 0.016).
Conclusion In patients with IPF who develop lung cancer, the rate of death from AE is higher than that in patients with IPF alone. They tend to have unusual CT patterns associated with AE, such as a peribronchial or asymmetric distribution.

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