- Patients with lung cancer who received prolonged high-dose steroid therapy (20 mg prednisolone equivalent per day for ≥3 weeks) and concurrent chemoradiotherapy (CCRT) had a higher risk of developing Pneumocystis jirovecii pneumonia (PJP) compared with patients who did not receive those therapies.
Why this matters
- Reports have emerged on PJP in patients with cancer, but little was known about the infection in lung cancer.
- PJP prophylaxis should be considered for high-risk patients.
- 112 patients with lung cancer and PJP and 336 patients with lung cancer and no PJP (control).
- Funding: None.
- Similar median age, sex, histopathology, and disease stage between groups.
- 59.8% of patients received steroids within 1 month of PJP diagnosis.
- 61.6% died during PJP treatment: 72.5% from respiratory failure, 14.5% from cancer progression, and 13.0% from respiratory failure with cancer progression.
- PJP was independently associated with prolonged high-dose steroid therapy (aOR, 1.96; P=.032) and CCRT (aOR, 2.09; P=.004).
- Surgery also was inversely associated with PJP (aOR, 0.42; P=.008), possibly because surgical patients were less likely to receive chemotherapy or radiotherapy.
- Retrospective, single-center study.