Lung Cancer: Lung Cancer IV |

Lung Carcinoma-binding Immunosupression, as The Risk Factor of The Development of the Live-Threating Pulmonary Infections FREE TO VIEW

Barbara Rybacka-Chabros, MD
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Medical University of Lublin, Lublin, Poland

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A326. doi:10.1016/j.chest.2016.02.339
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SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: The lung carcinoma-binding immunosupression may leads to severe, live-threating pulmonaty infections caused by different microorganisms. About 40% cases of patients with lung carcinoma represent bactericidal or fungal colonization of pulmonary tract. The aim of the study was evaluation the influence of oportunistic infections on response to chemotherapy or radiotherapy, quality of live and overall survival in patients with different stages of lung carcinoma.

METHODS: We analyzed 218 patients with lung carcinoma,135 males nad 83 females, aged 45-80 years. (mean 68,3 year). 167 (76,9%) subjetcs suffered from non-small-cell lung carcinoma and 51 (23,1%) subjects suffered from small-cell lung carcinoma in different stages of disease. All patients received the proper oncological management like chemotherapy, radiotherapy or the best supportive care. The bronchoalveolar lavage was obtained during bronchoscopy and examined directly by microscopic technique. Simultaneously, detection of microorganisms which were groving on the culture, was conducted. The quality of live was evaluated by proper questionnaire. The response on oncological management we evaluated by computed tomography, with 6 months follow-up period.

RESULTS: In examined specimens the following microorganisms were identified: Klebsiella pneumoniae, Escherichia coli, Streptococcus pneumoniae, Staphylococcus aureus, Mycobacterium avium complex, Aspergillus fumigatus, Candida albicans. In elderly over 60 years, severe concomitant infectionsoccured more frequently than in younger population. In 98 patients (40,5%) the proper oncological management was delayed becouse active infection, and response to anti-cancer therapy was worse than the rest without active infection. In 180 patients (82,2%) active bactericidal or fungal infection negatively influenced on quality of live and overall survival. 25 (12,4%) patients died becouse neutropenic fever.

CONCLUSIONS: Immunosupression caused by carcinogenesis, chemotherapy and radiotherapy in study patients with lung carcinoma, was the important risk factor of pulmonary infections development. This situation influenced on quality of live, response to the oncologic therapy and overall survival of study patients, especially in elderly over 60 years.

CLINICAL IMPLICATIONS: In patients with lung carcinoma, infectious watchfulmess should be recommended. Active pulnonary infection in this population significantly ifluences on the final result of oncologic therapy, especially in older patients.

DISCLOSURE: The following authors have nothing to disclose: Barbara Rybacka-Chabros

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