Non-small cell lung cancer (NSCLC) patients are often complicated by other respiratory diseases, including interstitial pneumonia (IP), chronic obstructive pulmonary disease (COPD), and pulmonary tuberculosis (TB), and the management of which can be problematic. NSCLC patients with IP sometimes develop fatal acute exacerbation induced by pharmacotherapy, and the establishment of a safe treatment strategy is desirable. For advanced NSCLC with IP, carboplatin plus nanoparticle albumin-bound paclitaxel is a relatively safe and effective first-line treatment option. Although the safety of immune checkpoint inhibitors (ICIs) for these populations remains controversial, ICIs have the potential to provide long-term survival. The severity of COPD is an important prognostic factor in NSCLC patients. Although COPD complications do not necessarily limit treatment options, it is important to select drugs with fewer side effects on the heart and blood vessels as well as the lungs. Active TB is complicated by 2–5% of NSCLC cases during their disease course. Since pharmacotherapy, especially ICIs, reportedly induces the development of TB, the possibility of developing TB should always be kept in mind during NSCLC treatment. To date, there is no coherent review article on NSCLC with these pulmonary complications. This review article summarizes the current evidence and discusses future prospects for treatment strategies for NSCLC patients complicated with IP, severe COPD, and TB.
非小细胞肺癌（NSCLC）患者常合并其他呼吸系统疾病，包括间质性肺炎（IP）、慢性阻塞性肺疾病（COPD）和肺结核（TB），这些合并症的处理往往具有挑战性。合并IP的NSCLC患者在接受药物治疗时可能发生致命的急性加重，因此建立安全的治疗策略至关重要。对于合并IP的晚期NSCLC患者，卡铂联合纳米白蛋白结合型紫杉醇是相对安全有效的一线治疗方案。尽管免疫检查点抑制剂（ICIs）对此类患者的安全性仍存争议，但ICIs可能为患者带来长期生存获益。COPD的严重程度是影响NSCLC患者预后的重要因素。虽然COPD合并症不一定限制治疗方案选择，但需优先选择对心血管及肺部副作用较小的药物。约2-5%的NSCLC患者在病程中合并活动性肺结核。现有报道显示药物治疗（特别是ICIs）可能诱发结核病，因此在NSCLC治疗过程中需始终警惕结核病发生的可能性。目前尚无针对合并上述肺部并发症的NSCLC的系统性综述。本文通过总结现有证据，探讨合并IP、重度COPD及TB的NSCLC患者治疗策略的现状与未来展望。
肿瘤(癌症)患者之家