The management of patients with NSCLC arising in the setting of chronic fibrotic lung diseases is a clinical challenge. Clinicians face difficulties in interpreting radiological findings and must navigate an increased susceptibility to treatment-related toxicities, such as acute exacerbation of interstitial lung disease (ILD) after surgery and pneumonitis after radiation or immunotherapy. This clinical dilemma is best characterized in idiopathic pulmonary fibrosis (IPF), in which the risk of lung cancer is fivefold higher than in the general population and prognosis is dismal.
The management of patients with NSCLC arising in the setting of chronic fibrotic lung diseases is a clinical challenge. Clinicians face difficulties in interpreting radiological findings and must navigate an increased susceptibility to treatment-related toxicities, such as acute exacerbation of interstitial lung disease (ILD) after surgery and pneumonitis after radiation or immunotherapy. This clinical dilemma is best characterized in idiopathic pulmonary fibrosis (IPF), in which the risk of lung cancer is fivefold higher than in the general population and prognosis is dismal.