Cancer Research and Treatment

Original Articles

Lung and Thoracic cancer

The Incidence and Risk Factors of Chronic Pulmonary Infection after Radiotherapy in Patients with Lung Cancer: Yeonseok Choi, Jae Myoung Noh, Sun Hye Shin, Kyungjong Lee, Sang-Won Um, Hojoong Kim, Hongryull Pyo, Yong Chan Ahn, Byeong-Ho Jeong; Cancer Res Treat. 2023;55(3):804-813. Published online January 3, 2023; DOI: https://doi.org/10.4143/crt.2022.1305

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Purpose
This study aimed to investigate cumulative incidence and risk factors associated with chronic pulmonary infection (CPI) development after radiotherapy for lung cancer.
Materials and Methods
We retrospectively analyzed 1,872 patients with lung cancer who received radiotherapy for lung cancer from 2010-2014, had a follow-up period of ≥ 3 months after radiotherapy, and did not have CPI at the time of radiotherapy. CPI was defined as pulmonary tuberculosis, non-tuberculous mycobacterial pulmonary disease, chronic pulmonary aspergillosis, or pulmonary actinomycosis. The cumulative incidence of CPI and overall survival (OS) were estimated using the Kaplan-Meier method, and a multivariable Cox proportional hazards analysis was performed to identify risk factors associated with CPI development.
Results
The median follow-up period was 2.3 years with OS rates of 55.6% and 37.6% at 2 and 5 years, respectively. CPI developed in 59 patients at a median of 1.8 years after radiotherapy, with cumulative incidence rates of 1.1%, 3.4%, 5.0%, and 6.8% at 1, 3, 5, and 7 years, respectively. A lower body mass index, interstitial lung disease, prior pulmonary tuberculosis, larger clinical target volume, history of lung cancer surgery or radiation pneumonitis, and use of inhaled corticosteroids were independent risk factors for CPI development.
Conclusion
The long-term survival rate of lung cancer patients receiving radiotherapy was not low, but the cumulative incidence of CPI gradually increased to 6.8% at 7 years after radiotherapy. Therefore, close monitoring of CPI development is required in surviving patients with risk factors.

Citations

Citations to this article as recorded by

Chronic progressive pulmonary aspergillosis within the irradiated field after stereotactic body radiotherapy: two case reports
Nao Mamuro, Noriko Kishi, Yukinori Matsuo, Masahiro Yoneyama, Hiroyuki Inoo, Minoru Inoue, Takashi Mizowaki
International Cancer Conference Journal.2025; 14(2): 113. CrossRef
Predictive nomogram for risk of pulmonary infection in lung cancer patients undergoing radiochemotherapy: development and performance evaluation
Yujie Huang
American Journal of Cancer Research.2025; 15(2): 781. CrossRef
The Inter-Relationships Among the Risk Factors for Pulmonary Infection and the Diagnostic Utility of Inflammatory Markers in Patients with Non-Small Cell Lung Cancer
Wenwen Qin, Tiebin You, Tai Guo, Ruixin Tian, Xiaoman Cui, Ping Wang
Infection and Drug Resistance.2025; Volume 18: 1111. CrossRef
Invasive aspergillosis complicated in a patient with non-small cell lung cancer harboring RET fusion during treatment with RET-TKIs: a case report and literature review
Kaidiriye Setiwalidi, Yimeng Li, Yuyan Ma, Zhanpeng Hao, Yujia Zhao, Yuxin Zhang, Xuan Liang, Tao Tian, Zhiping Ruan, Yu Yao, Xiao Fu
Frontiers in Oncology.2024;[Epub] CrossRef

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Impact of Pulmonary Tuberculosis on the EGFR Mutational Status and Clinical Outcome in Patients with Lung Adenocarcinoma: In Kyoung Hwang, Seung Sook Paik, Seung Hyeun Lee; Cancer Res Treat. 2019;51(1):158-168. Published online April 2, 2018; DOI: https://doi.org/10.4143/crt.2018.084

Abstract PDF Supplementary Material PubReader ePub

Purpose
Although it has been suggested that pulmonary tuberculosis (TB) is associated with increased risk of lung cancer, the exact mechanism is not clearly identified. We investigated the effect of pulmonary TB on the epidermal growth factor receptor (EGFR) mutational status and clinical outcome in patients with pulmonary adenocarcinoma.
Materials and Methods
We reviewed data of patients diagnosed with pulmonary adenocarcinoma harboring EGFR mutations and treated at our institution from 2008 to 2015. We divided our population into two groups: patients with pre-existing TB lesions on chest computed tomography scan (TB group) and those without the lesions (non-TB group). We compared the differences in EGFR mutational status, response to tyrosine kinase inhibitors (TKIs) and survival between the two groups.
Results
A total of 477 patients with pulmonary adenocarcinoma were analyzed. One hundred eighty-three patients (39%) had EGFR-mutated tumors and 100 (21%) patients had pre-existing TB lesions. The frequency of EGFR mutation was significantly higher in the TB group compared with the non-TB group (56% vs. 34%, p=0.038). Pre-existing TB lesions were independently associated with more frequent EGFR mutations in multivariate analysis (odds ratio, 1.43). In addition, both the progression-free survival (9.1 months vs. 11.6 months, p=0.020) and the overall survival (19.4 months vs. 24.5 months, p=0.014) after first-line EGFR-TKIs were significantly shorter in the TB group than in the non-TB group.
Conclusion
Previous pulmonary TB may be associated with more frequent EGFR mutations and poorer treatment response to EGFR-TKIs in patients with pulmonary adenocarcinoma.

Citations

Citations to this article as recorded by

A DNA Methylation Signature From Buccal Swabs to Identify Tuberculosis Infection
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Cancer Innovation.2025;[Epub] CrossRef
Progress in mechanism-based diagnosis and treatment of tuberculosis comorbid with tumor
Chuan Wang, Rong-Qi Zou, Guo-Zhong He
Frontiers in Immunology.2024;[Epub] CrossRef
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G. M. Agafonov, G. G. Kudriashov, U. S. Krylova, T. S. Zubareva, I. M. Kvetnoy, P. K. Yablonskiy
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Frontiers in Microbiology.2023;[Epub] CrossRef
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Abhay Vashishth, Mohd Shuaib, Tanya Bansal, Shashank Kumar
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Nadira Putri Nastiti, Laksmi Wulandari, Sulistiawati Sulistiawati, Anna Febriani, Wiwin Is Effendi
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Previous pulmonary tuberculosis enhances the risk of lung cancer: systematic reviews and meta-analysis
Hossein Abdeahad, Maryam Salehi, Atieh Yaghoubi, Amir Hossein Aalami, Farnoosh Aalami, Saman Soleimanpour
Infectious Diseases.2022; 54(4): 255. CrossRef
Pulmonary Tuberculosis and Risk of Lung Cancer: A Systematic Review and Meta-Analysis
Soo Young Hwang, Jong Yeob Kim, Hye Sun Lee, Sujee Lee, Dayeong Kim, Subin Kim, Jong Hoon Hyun, Jae Il Shin, Kyoung Hwa Lee, Sang Hoon Han, Young Goo Song
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Quantitative analysis of cell-free DNA by droplet digital PCR reveals the presence of EGFR mutations in non-malignant lung pathologies
Rajesh Venkataram, Srividya Arjuna, Giridhar Belur Hosmane, Anirban Chakraborty
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Concomitant Pulmonary Tuberculosis Impair Survival in Advanced Epidermal Growth Factor Receptor (EGFR) Mutant Lung Adenocarcinoma Patients Receiving EGFR-Tyrosine Kinase Inhibitor
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Caibao Jin, Bin Yang
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9,666 View
282 Download
17 Web of Science
18 Crossref

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