Experience with perioperative pirfenidone for lung cancer surgery in patients with idiopathic pulmonary fibrosis

被引：49
|
作者：
Iwata, Takekazu [1 ]
Yoshida, Shigetoshi [1 ]
Nagato, Kaoru [1 ]
Nakajima, Takahiro [1 ]
Suzuki, Hidemi [1 ]
Tagawa, Tetsuzo [1 ]
Mizobuchi, Teruaki [1 ]
Ota, Satoshi [2 ]
Nakatani, Yukio [2 ]
Yoshino, Ichiro [1 ]
机构：
[1] Chiba Univ, Grad Sch Med, Dept Gen Thorac Surg, Chuo Ku, Chiba, Chiba 2608670, Japan
[2] Chiba Univ, Grad Sch Med, Dept Diagnost Pathol, Chuo Ku, Chiba, Chiba 2608670, Japan
来源：
SURGERY TODAY | 2015年 / 45卷 / 10期
关键词：
Acute exacerbation; Idiopathic pulmonary fibrosis; Lung cancer; Surgery; Pirfenidone; POSTOPERATIVE ACUTE EXACERBATION; INTERSTITIAL PNEUMONIA; RESECTION; DISEASE; RISK; CHEMOTHERAPY; SURVIVAL; EFFICACY; TRIAL; KL-6;
D O I：
10.1007/s00595-014-1071-5
中图分类号：
R61 [外科手术学];
学科分类号：
摘要：
Idiopathic pulmonary fibrosis (IPF) is a progressive diffuse lung disease associated with an increased risk of lung cancer. Patients with IPF sometimes develop a life-threatening acute exacerbation of IPF (AE-IPF) after lung cancer surgery. In this retrospective study, pirfenidone, an antifibrotic agent, was perioperatively administered to IPF patients with lung cancer with the aim of preventing postoperative AE-IPF, and the feasibility and clinical outcomes were investigated. Twelve IPF patients with concomitant lung cancer who received perioperative pirfenidone treatment (PPT) for lung cancer surgery were retrospectively investigated. Sixteen IPF patients undergoing lung cancer surgery without PPT were analyzed as historical controls. Compared to the controls, the PPT patients had a more severely impaired preoperative pulmonary function and a larger number of limited pulmonary resections. There was a significant preoperative decrease in the serum KL-6 levels of the PPT patients. No severe pirfenidone-related complications or IPF-related events occurred in the PPT patients, while six control patients developed AE-IPF (P = 0.0167). A quantitative histopathological evaluation of resected lung specimens found that tissue changes associated with IPF were significantly fewer in the PPT patients (P = 0.021). PPT is a feasible perioperative treatment for IPF patients with lung cancer. Its effectiveness in preventing postoperative AE-IPF thus warrants prospective verification.
引用
收藏
页码：1263 / 1270
页数：8
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