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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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Abstract
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Supplementary Material
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ePub - 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
- A Meta‐Analysis on the Incidence and Associated Factors of Pulmonary Fungal Infections in Lung Cancer Patients: Evidence Predominantly From Chinese Studies in the Chinese and English Literature
Liping Deng, Rong Yu, Bei Chen
Thoracic Cancer.2026;[Epub] CrossRef - External validation and updating of NTCP models for radiation pneumonitis: QUANTEC, Appelt, and a local simplified model
Zhi Chen, Heng Li, Lan Liang, Ming Fan, Shunping Huang, Peng Xue, Rui Kong, Zhenzhou Yang, Zhengjun Guo
Frontiers in Oncology.2026;[Epub] CrossRef - 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 - Incidence and predictors of pulmonary aspergillosis in patients with lung cancer: a systematic review and meta-analysis
Geling Teng, Feng Jin, Hua Zhang, Min Zhang
Frontiers in Medicine.2025;[Epub] CrossRef - Host Risk Factors for Tuberculosis
Vahid Asgharzadeh, Seyyed Amin Seyyed Rezaei, Mohammad Asgharzadeh, Jalil Rashedi, Hossein Samadi Kafil, Hossein Jalaei Nobari, Ahmad Ali Khalili, Mortaza Raeisi, Mahdi Asghari Ozma, Behroz Mahdavi Poor
Infectious Disorders - Drug Targets.2025;[Epub] CrossRef - Interaction between Dectin-1 gene polymorphisms and low weight on the risk of invasive pulmonary aspergillosis in patients with lung cancer undergoing surgery
Wenfang Jin, Yu Yao, Yanling Lv
Discover Oncology.2025;[Epub] CrossRef - Coexisting Lung Cancer and Pulmonary Tuberculosis: A Comprehensive Review From Incidence to Management
Wendi Zhou, Hongxu Lu, Jiamin Lin, Jialou Zhu, Jizhen Liang, Yalin Xie, Jinxing Hu, Ning Su
Cancer Reports.2025;[Epub] CrossRef - Risk factors for pulmonary infection after thoracoscopic radical resection of lung cancer in elderly patients with diabetes mellitus
Zi-Yuan Chen, Zhi-Qi Hong, Tie-Qiao Wang, Guo-Mei-Zhi Fu, Wen-Min Su, Cheng-Wei Zhou
World Journal of Diabetes.2025;[Epub] CrossRef - Clinical Analysis of Preoperative Nebulized Inhalation of Budesonide in Reducing Postoperative Complications in Patients Undergoing Lobectomy
紫燕 姚
Nursing Science.2025; 14(10): 1920. CrossRef - Global trends, risk factors, and therapeutic associations of fungal pulmonary infections in lung cancer: A systematic review and meta-analysis
Milad Sheervalilou1, Mostafa Ghanei1, Masoud Arabfard1
Jornal Brasileiro de Pneumologia.2025; : e20250076. CrossRef - Tuberculosis and Lung Cancer: Insights from a Narrative Review
Antonio-Andrei Cotea, Ancuta-Alina Constantin, Florin-Dumitru Mihaltan
Cancers.2025; 18(1): 83. 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
- A Meta‐Analysis on the Incidence and Associated Factors of Pulmonary Fungal Infections in Lung Cancer Patients: Evidence Predominantly From Chinese Studies in the Chinese and English Literature
- 8,026 View
- 210 Download
- 12 Web of Science
- 14 Crossref
- 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
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Abstract
PDFSupplementary MaterialPubReaderePub
- 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- Case Report: Bronchiolar Squamous Cell Metaplasia in Pulmonary Tuberculosis: A Rare Case Report and short Review of Pathogenesis
Dariya Chivchibashi-Pavlova, Daniel Rajan, Deyan Dzhenkov
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Sungmin Zo, Hayoung Choi, Sang Hyuk Kim, Ye Eun Yoon, Jae Won Yun, Hyun Lee
Journal of Korean Medical Science.2026;[Epub] CrossRef - Analysis of tuberculosis and multiple diseases as co-morbidities: a narrative review
Yaqi Sun, Kaixin Zhou, Wenhui Wang, Qian Gao, Yan Lin
Annals of Medicine.2026;[Epub] CrossRef - A DNA Methylation Signature From Buccal Swabs to Identify Tuberculosis Infection
Lovisa Karlsson, Isabelle Öhrnberg, Shumaila Sayyab, David Martínez-Enguita, Mika Gustafsson, Patricia Espinoza, Melissa Méndez-Aranda, Cesar Ugarte-Gil, Lameck Diero, Ronald Tonui, Jakob Paues, Maria Lerm
The Journal of Infectious Diseases.2025; 231(1): e47. CrossRef - Contagious illness of tuberculosis and correlation with various types of cancer
Karthikeyan Sundaram, Venkataraman Prabhu
Medicine in Microecology.2025; 24: 100123. CrossRef - Coexistent Pulmonary Tuberculosis and Lung Cancer: An Analysis of Incidence Trends, Financial Burdens and Influencing Factors
Fei Qi, Hongjie Yang, Yi Han, Yujie Dong, Fan Zhang, Yishuo Wang, Juan Du, Yuan Gao, Xueguang Hu, Liqun Zhang, Tongmei Zhang
Cancer Innovation.2025;[Epub] CrossRef - Coexisting Lung Cancer and Pulmonary Tuberculosis: A Comprehensive Review From Incidence to Management
Wendi Zhou, Hongxu Lu, Jiamin Lin, Jialou Zhu, Jizhen Liang, Yalin Xie, Jinxing Hu, Ning Su
Cancer Reports.2025;[Epub] CrossRef - New Vistas in Mycobacterium tuberculosis Infection and Its Association with Lung Cancer Development
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Cancers.2025; 17(13): 2224. CrossRef - Real-world progression-free survival of first line afatinib patients with EGFR-mutant advanced lung adenocarcinoma: A multicentre study in Indonesia
Noni Novisari Soeroso, Elisna Syahruddin, Chaliza Soliha, Laksmi Wulandari, Ana Rima Setijadi, Sabrina Ermayanti, Suryanti Dwi Pratiwi, Andreas Infianto, Novita Andayani, Sri Melati Munir, Avissena Dutha Pratama, Ida Ayu Jasminarti Dwi Kusumawardani, Hary
Cancer Treatment and Research Communications.2025; 44: 100979. CrossRef - Tuberculosis Coinciding With Epidermal Growth Factor Receptor (EGFR)-Mutant Lung Adenocarcinoma: A Diagnostic Conundrum
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Frontiers in Cellular and Infection Microbiology.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 - Lung cancer and pulmonary tuberculosis: key features of molecular mechanisms of concomitant disease
G. M. Agafonov, G. G. Kudriashov, U. S. Krylova, T. S. Zubareva, I. M. Kvetnoy, P. K. Yablonskiy
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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
Journal of Clinical Medicine.2022; 11(3): 765. CrossRef - Clinical and pathological characteristics associated with the presence of the IS6110 Mycobacterim tuberculosis transposon in neoplastic cells from non-small cell lung cancer patients
Oscar Arrieta, Camilo Molina-Romero, Fernanda Cornejo-Granados, Brenda Marquina-Castillo, Alejandro Avilés-Salas, Gamaliel López-Leal, Andrés F. Cardona, Alette Ortega-Gómez, Mario Orozco-Morales, Adrián Ochoa-Leyva, Rogelio Hernandez-Pando
Scientific Reports.2022;[Epub] CrossRef - Lung cancer occurrence after an episode of tuberculosis: a systematic review and meta-analysis
Javier Cabrera-Sanchez, Vicente Cuba, Victor Vega, Patrick Van der Stuyft, Larissa Otero
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Reema Bansal, Mohd M. Khan, Surendra Dasari, Indu Verma, David R. Goodlett, Nathan P. Manes, Aleksandra Nita-Lazar, Surya P. Sharma, Aman Kumar, Nirbhai Singh, Anuradha Chakraborti, Vishali Gupta, M.R. Dogra, Jagat Ram, Amod Gupta
Tuberculosis.2021; 126: 102036. CrossRef - Epidermal growth factor receptor-mutant pulmonary adenocarcinoma coexisting with tuberculosis
Ning Liu, Lingnan Zheng, Min Yu, Shuang Zhang
Medicine.2021; 100(8): e24569. CrossRef - Quantitative analysis of cell-free DNA by droplet digital PCR reveals the presence of EGFR mutations in non-malignant lung pathologies
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Monaldi Archives for Chest Disease.2021;[Epub] CrossRef - Concomitant Pulmonary Tuberculosis Impair Survival in Advanced Epidermal Growth Factor Receptor (EGFR) Mutant Lung Adenocarcinoma Patients Receiving EGFR-Tyrosine Kinase Inhibitor
Yalin Xie, Ning Su, Wei Zhou, An Lei, Xiang Li, Weiwei Li, Zhan Huang, Wenchang Cen, Jinxing Hu
Cancer Management and Research.2021; Volume 13: 7517. CrossRef - A Case of Delayed Diagnostic Pulmonary Tuberculosis during Targeted Therapy in an EGFR Mutant Non-Small Cell Lung Cancer Patient
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Case Reports in Oncology.2021; 14(1): 659. CrossRef - Follow‐up of an occult tuberculosis scar cancer after resection of metastatic lesions
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Thoracic Cancer.2020; 11(8): 2347. CrossRef
- Case Report: Bronchiolar Squamous Cell Metaplasia in Pulmonary Tuberculosis: A Rare Case Report and short Review of Pathogenesis
- 12,577 View
- 288 Download
- 21 Web of Science
- 26 Crossref
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