表皮生长因子受体酪氨酸激酶抑制剂治疗与中度至重度眼表疾病相关的风险：一项多中心队列研究

IF 3.2 3区医学 Q2 OPHTHALMOLOGY

Ophthalmology and Therapy Pub Date : 2025-07-17 DOI:10.1007/s40123-025-01200-4

Yu-Ting Tsao, Eugene Yu-Chuan Kang, Chiao-En Wu, Ning Hung, Hung-Chi Chen, Ching-Hsi Hsiao

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引用次数: 0

摘要

中度至重度眼表疾病（OSD）可严重损害接受表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKI）治疗的肺癌患者的生活质量。虽然有多项研究报道了与EGFR-TKI治疗相关的OSD病例，但很少有研究调查主要危险因素。在这项研究中，我们研究了接受EGFR-TKI治疗的肺癌患者中至重度OSD的关键危险因素。方法：这项多中心回顾性（2004年11月- 2019年12月）队列研究纳入了31491例肺癌患者。中度至重度OSD定义为严重结膜炎、干眼病需要至少第2步治疗、角膜炎、角膜溃疡、角膜穿孔或OSD需要手术治疗。采用单因素和多因素Cox比例风险模型调查中度至重度OSD的危险因素。结果：6677例接受EGFR-TKI治疗的患者中，220例（3.3%）发生中至重度OSD。多因素分析显示以下独立危险因素：女性(危险比[HR]: 1.43；95% CI: 1.08-1.90)，既往眼部手术(HR: 4.15；95% CI: 1.54-11.21)，年龄较大(HR: 1.16；95% CI: 1.03-1.31)，自身免疫性疾病(HR: 3.38；95% CI: 1.38-8.25)，消化性溃疡(HR: 1.90；95% CI: 1.35-2.68)，甲状腺疾病(HR: 2.34；95% CI: 1.03-5.28)和全身性类固醇使用(HR: 1.50；95% ci: 1.13-1.97)。以下是严重OSD的特定危险因素：远处转移(HR: 3.29；95% CI: 1.16-9.28)，既往放疗(HR: 2.29；95% CI: 1.13-4.65)，甲状腺疾病(HR: 3.78；95% CI: 1.15-12.40)和较高的Charlson合并症指数评分(HR: 1.11；95% ci: 1.01-1.23)。结论：具有上述危险因素的患者在EGFR-TKI治疗期间发生中重度OSD的风险升高。眼科医生和肿瘤学家对高危人群的早期识别和及时干预可能会减缓疾病进展并改善生活质量。

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Risk of Moderate to Severe Ocular Surface Disease Associated with Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor Therapy: A Multicenter Cohort Study.

Introduction: Moderate to severe ocular surface disease (OSD) can substantially impair quality of life in patients with lung cancer receiving epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) therapy. Although multiple studies have reported cases of OSD associated with EGFR-TKI therapy, few have investigated major risk factors. In this study, we investigated the key risk factors for moderate to severe OSD in patients with lung cancer receiving EGFR-TKI therapy.

Methods: This multicenter retrospective (November 2004-December 2019) cohort study included 31,491 patients with lung cancer. Moderate to severe OSD was defined as severe conjunctivitis, dry eye disease necessitating at least step 2 treatment, keratitis, corneal ulcer, corneal perforation, or OSD necessitating surgery. Risk factors for moderate to severe OSD were investigated using univariate and multivariate Cox proportional hazards models.

Results: Among 6677 eligible patients who received EGFR-TKI therapy, 220 (3.3%) developed moderate to severe OSD. Multivariate analysis revealed the following independent risk factors: female sex (hazard ratio [HR]: 1.43; 95% CI: 1.08-1.90), prior ocular surgery (HR: 4.15; 95% CI: 1.54-11.21), older age (HR: 1.16; 95% CI: 1.03-1.31), autoimmune disease (HR: 3.38; 95% CI: 1.38-8.25), peptic ulcer (HR: 1.90; 95% CI: 1.35-2.68), thyroid disease (HR: 2.34; 95% CI: 1.03-5.28), and systemic steroid use (HR: 1.50; 95% CI: 1.13-1.97). The following were specific risk factors for severe OSD: distant metastasis (HR: 3.29; 95% CI: 1.16-9.28), prior radiotherapy (HR: 2.29; 95% CI: 1.13-4.65), thyroid disease (HR: 3.78; 95% CI: 1.15-12.40), and high Charlson Comorbidity Index scores (HR: 1.11; 95% CI: 1.01-1.23).

Conclusion: Patients with the identified risk factors are at an elevated risk of moderate to severe OSD during EGFR-TKI therapy. Early recognition and timely intervention by ophthalmologists and oncologists in high-risk individuals may mitigate disease progression and improve quality of life.

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来源期刊

Ophthalmology and Therapy OPHTHALMOLOGY-

CiteScore

4.20

自引率

3.00%

发文量

157

审稿时长

6 weeks

期刊介绍： Aims and Scope Ophthalmology and Therapy is an international, open access, peer-reviewed (single-blind), and rapid publication journal. The scope of the journal is broad and will consider all scientifically sound research from preclinical, clinical (all phases), observational, real-world, and health outcomes research around the use of ophthalmological therapies, devices, and surgical techniques. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/series, trial protocols and short communications such as commentaries and editorials. Ophthalmology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. Rapid Publication The journal’s publication timelines aim for a rapid peer review of 2 weeks. If an article is accepted it will be published 3–4 weeks from acceptance. The rapid timelines are achieved through the combination of a dedicated in-house editorial team, who manage article workflow, and an extensive Editorial and Advisory Board who assist with peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model this allows for the rapid, efficient communication of the latest research and reviews, fostering the advancement of ophthalmic therapies. Open Access All articles published by Ophthalmology and Therapy are open access. Personal Service The journal’s dedicated in-house editorial team offer a personal “concierge service” meaning authors will always have an editorial contact able to update them on the status of their manuscript. The editorial team check all manuscripts to ensure that articles conform to the most recent COPE, GPP and ICMJE publishing guidelines. This supports the publication of ethically sound and transparent research. Digital Features and Plain Language Summaries Ophthalmology and Therapy offers a range of additional features designed to increase the visibility, readership and educational value of the journal’s content. Each article is accompanied by key summary points, giving a time-efficient overview of the content to a wide readership. Articles may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand the scientific content and overall implications of the article. The journal also provides the option to include various types of digital features including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations. All additional features are peer reviewed to the same high standard as the article itself. If you consider that your paper would benefit from the inclusion of a digital feature, please let us know. Our editorial team are able to create high-quality slide decks and infographics in-house, and video abstracts through our partner Research Square, and would be happy to assist in any way we can. For further information about digital features, please contact the journal editor (see ‘Contact the Journal’ for email address), and see the ‘Guidelines for digital features and plain language summaries’ document under ‘Submission guidelines’. For examples of digital features please visit our showcase page https://springerhealthcare.com/expertise/publishing-digital-features/ Publication Fees Upon acceptance of an article, authors will be required to pay the mandatory Rapid Service Fee of €5250/$6000/£4300. The journal will consider fee discounts and waivers for developing countries and this is decided on a case by case basis. Peer Review Process Upon submission, manuscripts are assessed by the editorial team to ensure they fit within the aims and scope of the journal and are also checked for plagiarism. All suitable submissions are then subject to a comprehensive single-blind peer review. Reviewers are selected based on their relevant expertise and publication history in the subject area. The journal has an extensive pool of editorial and advisory board members who have been selected to assist with peer review based on the afore-mentioned criteria. 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