Idiopathic pulmonary fibrosis in hospitalized patients with lung cancer

<bold>Background:</bold> Lung cancer (LC) is a common and lethal comorbidity of idiopathic pulmonary fibrosis (IPF), and concomitant IPF severely interferes with the management of LC in patients. <bold>Methods:</bold> A retrospective analysis was conducted on hospitalized LC patients with IPF from 2014 to 2021. <bold>Results:</bold> 92 patients were diagnosed with LC with concomitant IPF (LC-IPF). There were 5 females and 87 males, aged 67.99±7.51 years (range: 49-89 years).82 patients had smoking history. There were obvious signs of emphysema in chest imaging in 69 patients. IPF was diagnosed before LC in 27 patients and was simultaneously diagnosed with LC in 65 patients. At the diagnosis of LC, the average pulse oxygen saturation at rest was 94.33±2.43%. Most LC-IPF patients in the study had late-stage LC, including 52 stage IV cases and 24 stage III cases. Common pathological patterns of LC were adenocarcinoma (35 cases, 0.4% of all adenocarcinoma cases during that period), squamous cell carcinoma (29 cases, 1.7%) and small cell lung cancer (29 cases, 2.1%). Surgery was performed in 20 patients. Three patients suffered from acute exacerbation of IPF after the surgery, and all of them survived. Nonsurgical treatment for LC included chemotherapy (70 cases), immunotherapy (20 cases), targeted therapy (15 cases) and radiotherapy (11 cases). As for the treatment of IPF, only 6 patients were treated with antifibrotic drugs. The median overall survival was 310 days since the diagnosis of LC for all LC-IPF patients, ranging from 22 days to 3945 days. Thirteen LC-IPF patients died of the progression of LC and/or IPF (6 of LC, 5 of IPF, 1 of both, and 1 of pulmonary embolism).