Lung cancer: high-dose steroids, CCRT tied to higher PJP risk

  • Lee EH & al.
  • Sci Rep
  • 14 Feb 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • 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. 

Study design

  • 112 patients with lung cancer and PJP and 336 patients with lung cancer and no PJP (control).
  • Funding: None.

Key results

  • 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.

Limitations

  • Retrospective, single-center study.

Please confirm your acceptance

To gain full access to GPnotebook please confirm:

By submitting here you confirm that you have accepted Terms of Use and Privacy Policy of GPnotebook.

Submit