Risk Score for Predicting Acute Exacerbation after Chemotherapy in Lung Cancer Associated with Interstitial Pneumonia

Fatal acute exacerbation (AE) of interstitial pneumonia (IP) may occur after chemotherapy for lung cancer. We developed and evaluated a scoring system for assessing the risk of AE after chemotherapy in patients with lung cancer associated with IP. A review of medical records identified 107 patients with primary lung cancer associated with IP who had received chemotherapy during the period from June 2007 through September 2017. We developed a model to scoring AE risk after chemotherapy in lung cancer patients with IP, and logistic regression was used to evaluate this model. The general score for anti-cancer agents was determined by using rates of AE reported in past studies. The risk score was calculated by using the following formula: (1 × anti-cancer agent general score) + (3 × smoking history [>70 pack-years]) + (4 × history of steroid medication) + (3 × %diffusing capacity of the lung carbon monoxide [<50%]). Patients were then classified into three groups. The AE rate was 12% for a risk score of 0–5, 47% for a score of 6–10, and 66.7% for a score ≥11. This sensitivity of the scoring system was 78.6%, and specificity was 67.8%. The present scoring system could identify IP patients at high risk for AE after chemotherapy for lung cancer.