Effect of 23-Valent Pneumococcal Polysaccharide Vaccine Inoculated During Anti-Cancer Treatment Period in Elderly Lung Cancer Patients on Community-Acquired Pneumonia Hospitalization

Chiou, Wen‐Yen; Hung, Shih‐Kai; Lai, Ching‐Huang; Lin, Hsing Ying; Su, Yu Chieh; Chen, Yi Chun; Shen, Bo; Chen, Liang Cheng; Tsai, Shiang Jiun; Lee, Moon Sing; Li, Chung‐Yi

doi:10.1097/md.0000000000001022

Cited by 30 publications

(22 citation statements)

References 27 publications

(35 reference statements)

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“… 27 Our pneumonia study in patients with lung cancer conducted earlier in Taiwan showed that PPSV23 inoculated during the active anticancer treatment period could effectively reduce risk of hospitalised pneumonia. 13 In this study, our results confirmed that PPSV23 can protect elderly long-term cancer survivors against pneumonia. Because the cost of PPSV23 is low, it can be considered a feasible strategy for coping with the high risk of pneumonia in elderly cancer survivors.…”

Section: Discussionsupporting

confidence: 80%

“… 29 The study by Chiou et al reported a much higher incidence of 444 per 1000 PYs in patients with lung cancer aged ≥75 years, which they attributed to much older age, immunocompromised status during cancer treatment and poor pulmonary function. 13 In the present study, the incidence rate in long-term cancer survivors aged ≥75 years was 117.82 per 1000 PYs. These data highlight the importance of pneumonia vaccination in the elderly population.…”

Section: Discussionmentioning

confidence: 44%

“… 12 However, our previous study demonstrated the effectiveness of the 23-valent pneumococcal polysaccharide vaccine (PPSV23) in patients with lung cancer even when given during the active anticancer treatment period. 13 …”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of 23-valent pneumococcal polysaccharide vaccine on elderly long-term cancer survivors: a population-based propensity score matched cohort study

et al. 2018

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ObjectiveThe Advisory Committee on Immunization Practices in 2012 recommended the 23-valent pneumococcal polysaccharide vaccine (PPSV23) for adults with high risk of pneumonia. However, its effectiveness in cancer survivors has not been investigated. Our aim was to investigate the effectiveness of PPSV23 in these patients.DesignPopulation-based matched cohort study.SettingClaim data were obtained from 1 million people registered with the National Health Insurance Research Database in 1996, and followed to 2010. People aged ≥75 years are eligible for receiving PPSV23 vaccination in Taiwan since 2007.ParticipantsAmong the 30 249 patients with cancer, 6784 patients were 75 years or older eligible for PPSV23 vaccination. Among them, 1887 survived 5 or more years (ie, cancer survivors) after cancer diagnosis. We identified 377 cancer survivors who received PPSV23. A total of 754 propensity score matched unvaccinated patients were randomly selected.InterventionPPSV23 vaccination.Primary outcome measuresThe primary outcome was pneumonia hospitalisation. Potential confounders include influenza vaccination, vaccination period, cancer treatment modalities, comorbidities and sociodemographic variables.ResultsAfter 2 years of follow-up, vaccinated patients had a significantly lower incidence rate of pneumonia hospitalisation at 73.66 per 1000 person-years (PYs), compared with 117.82 per 1000 PYs for unvaccinated patients. Additionally, the prevalence for pneumonia hospitalisation frequency of >0–1,>1–2,>2–3 and >3 times per PY was all consistently lower in the vaccinated group (6.63% vs 9.28%, 1.86% vs 2.52%, 0.80% vs 1.59% and 0.27% vs 0.53%, respectively). After adjustment for covariates, PPSV23 vaccine was significantly associated with reduced pneumonia hospitalisation risk, with an adjusted incidence rate ratio of 0.695 (p=0.030). While the cumulative pneumonia incidence was also significantly lower in the vaccinated patients (p=0.027), the overall survival time was similar (p=0.136).ConclusionsPPSV23 vaccination was associated with a significantly reduced rate of pneumonia hospitalisation in long-term cancer survivors.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 44%

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Effectiveness of 23-valent pneumococcal polysaccharide vaccine on elderly long-term cancer survivors: a population-based propensity score matched cohort study

et al. 2018

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“…Second, our study did not investigate whether pneumococcal vaccine (PSV 23 or PCV 13) was given. Chiou et al [34] noted that the cumulative hospitalization rate for pneumonia over two years in lung cancer patients was 37.1% in the vaccinated group and 55.4% in the non-vaccinated group. Third, exclusion of radiation pneumonitis was not complete because differential diagnosis between pneumonia and radiation pneumonia was based on retrospective medical chart and radiologic findings reviews.…”

Section: Discussionmentioning

confidence: 99%

Smoking is associated with pneumonia development in lung cancer patients

Heo

Yeo

Park

et al. 2020

Preprint

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Background: Various host factors can promote pneumonia susceptibility of lung cancer patients. However, data about risk factors for pneumonia in lung cancer patients receiving active treatments such as chemotherapy, radiotherapy, and surgical intervention are limited. Thus, the purpose of this study was to identify risk factors for pneumonia development in lung cancer patients. Methods: The present study used a lung cancer cohort of the Catholic Medical Center at the Catholic University of Korea from January 2015 to December 2018. Pneumonia was defined by the presence of a new or progressive infiltration on chest imaging together with any of the following: new onset purulent sputum, change in character of chronic sputum, and fever. We ruled out noninfectious infiltration such as drug or radiation toxicity and hydrostatic pulmonary edema. We especially excluded those if computed tomography revealed sharp demarcation consolidation or ground glass opacity limited radiation field. Results: A total of 413 patients were enrolled in this study. Pneumonia occurred in 118 (28.6%) patients. The pneumonia group had significantly worse overall survival (OS) than the non-pneumonia group (456.7 ± 35.0 days vs. 813.4 ± 36.1 days, log rank p < 0.001). In patients with pneumonia, OS was shorter in ex-smokers and current smokers than in never smokers (592.0 ± 101.0 days vs. 737.0 ± 102.8 days vs. 1357.0 days, log rank p < 0.001). Age (hazard ratio [HR]: 1.046; 95% confidence interval [CI]: 1.019¬–1.074; p = 0.001), clinical stage IV (HR: 1.759; 95% CI: 1.004–3.083; p = 0.048), neutropenia (HR: 2.620; 95% CI: 1.562–4.396; p < 0.001], and smoking (HR: 2.040; 95% CI: 1.100–3.784; p = 0.024) were independent risk factors of pneumonia development in lung cancer patients in multivariate analysis. In subgroup analysis for patients treated with chemotherapy, age (HR: 1.043; 95% CI: 1.012–1.074; p = 0.006), neutropenia (HR: 3.199; 95% CI: 1.826–5.605; p < 0.001), and smoking (HR: 2.125; 95% CI: 1.071–4.216; p = 0.031) were independent risk factors of pneumonia development.Conclusions: Smoking and neutropenia were risk factors affecting pneumonia development in the total group and subgroup of patients with lung cancer.

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“…In the article “Effect of 23-Valent Pneumococcal Polysaccharide Vaccine Inoculated During Anti-Cancer Treatment Period in Elderly Lung Cancer Patients on Community-Acquired Pneumonia Hospitalization: A Nationwide Population-Based Cohort Study”, 1 which appeared in Volume 94, Issue 26 of Medicine , an incorrect version of Figure 1 appeared. The article has since been corrected online.…”

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confidence: 99%