TY - JOUR T1 - Computed tomography patterns in patients with cytotoxic drug-induced pulmonary toxicity JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2016.PA3924 VL - 48 IS - suppl 60 SP - PA3924 AU - Hiroki Umezawa AU - Yusuke Naito AU - Jiro Terada AU - Kenji Tsushima AU - Koichiro Tatsumi Y1 - 2016/09/01 UR - http://erj.ersjournals.com/content/48/suppl_60/PA3924.abstract N2 - Background: Computed tomography (CT) appearance in pulmonary toxicity of antineoplastic drugs has various patterns. A diffuse alveolar damage (DAD) pattern on CT images was correlated with poor prognosis in patients with gefitinib-induced lung injury (Endo M, et al. Lung Cancer 2006; 52:135-140). However, the association between the CT findings and clinical outcomes remains unclear in cases of conventional cytotoxic drug-induced pulmonary toxicity (CDPT).Objectives: We aimed to analyze the imaging features of CT in cases of CDPT and to elucidate the relationship between the CT patterns and prognosis.Methods: We performed a retrospective review of 28 patients with CDPT at Chiba University Hospital from 2005 to 2015.Results: The CT findings of CDPT were classified into one of five predominant patterns; DAD (n = 11), hypersensitivity pneumonitis (HP) (n = 6), eosinophilic pneumonia (EP) (n = 5), organizing pneumonia (OP) (n = 4), and chronic interstitial pneumonia (CIP) (n = 2). The 90-day mortality rate was significantly higher in the patients with a DAD pattern (DAD-group) than the patients without a DAD pattern (non-DAD group) (64% vs 6%, p = 0.0007). Serum levels of LDH, CRP and KL-6 were significantly elevated in the DAD group compared with the non-DAD group (p = 0.029, 0.032 and 0.023, respectively). Univariate analyses revealed that a DAD pattern on CT images was the only significant factor for 90-day mortality (p = 0.006).Conclusion: The CT findings with a DAD pattern indicate unfavorable outcomes in patients with CDPT. Classification of the CT patterns of CDPT into DAD or non-DAD seems to be practically useful to predict prognosis. ER -