Clinical and prognostic characteristics of concurrent small cell lung cancer in patients with idiopathic pulmonary fibrosis: a retrospective study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Lung cancer (LC) is a comorbidity that seriously affects the prognosis of idiopathic pulmonary fibrosis (IPF) patients. Small cell LC (SCLC) accounts for the highest proportion of hospitalized LC patients with concurrent IPF at Peking Union Medical College Hospital (PUMCH). To enable effective and standardized management of patients with IPF and SCLC, this study aims to summarize the clinical and prognostic characteristics of IPF-SCLC patients to improve their prognosis. Methods: We retrospectively enrolled patients with IPF (diagnosed by 2022 ATS/ERS/JRS/ALAT criteria)-SCLC (pathologically confirmed) admitted to PUMCH from January 2014 to December 2023. Clinical manifestation, chest computed tomography (CT) imaging, laboratory test, treatment and outcome data of patients with IPF-SCLC were collected and reviewed in detail with final follow-up on June 30, 2024. Results: Forty patients with IPF-SCLC were included with the average age of 68.2±6.3 years (range, 54 to 82 years). And there were 37 (92.5%) males. Median follow-up time was 12.0 months. Additionally, 35 (87.5%) patients had a smoking history. Twenty-eight (70.0%) IPF-SCLC patients were concurrent with one or more other underlying diseases. Emphysema was detected in 26 (65%) patients via chest CT. IPF and SCLC were diagnosed during the same period in 23 (57.5%) patients, whereas SCLC was diagnosed during the follow-up of IPF in the remaining 17 patients. However, pirfenidone and nintedanib were only prescribed to two patients, respectively. Most patients were diagnosed with late-stage SCLC: 17 (42.5%) patients had stage IV SCLC, and 15 (37.5%) patients had stage III SCLC. Furthermore, with respect to anticancer therapy, one (2.5%) patient received no chemotherapy, 2 (5%) patients received oral etoposide, 37 (92.5%) patients received intravenous chemotherapy, and 11 (27.5%) patients received pulmonary radiotherapy. Finally, 29 (72.5%) patients died during follow-up. The main causes of death were acute exacerbation of IPF (AE-IPF) (13 patients, 44.8%) and progression of SCLC (12 patients, 41.4%). Conclusions: The patients with IPF-SCLC included in our studies were mainly elderly males with a heavy smoking index, most of whom were diagnosed with late-stage SCLC. Antifibrotic medications for IPF were uncommon, and chemotherapy was the main cancer treatment. The progression of uncontrolled SCLC and AE-IPF were the main causes of death. Clinicians should consider early initiation of antifibrotic therapy alongside chemotherapy, monitor for the occurrence of AE-IPF, and adopt multidisciplinary management.
Source: Journal of Thoracic Disease
Language: English
Topic: Lung Cancer Research Studies
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7224135632