Introduction
According to the 2020 Global Cancer Statistics report, there were
220,677 new cases of lung cancer worldwide, resulting in 1,796,144
deaths. Lung cancer accounts for 11.4% of all new cancer cases globally
and 18% of cancer-related deaths. Compared to global averages, China
has seen a high incidence and mortality rate of lung cancer, ranking
first among all cancer types in terms of incidence and
mortality[1,2]. As per the 2020 World Health Organization report,
over 10 million new cases of tuberculosis (TB) were reported worldwide,
with 1.4 million deaths attributed to the disease, marking it as one of
the top global public health concerns. The incidence and mortality rates
of pulmonary tuberculosis in China have consistently been at the
forefront among Class A and B infectious diseases[3], especially in
the Sichuan region where it is prevalent. The primary treatments for
lung cancer include chemotherapy, radiation therapy, and targeted
therapies, often combining systemic and localized treatments. In
contrast, the main treatment for pulmonary tuberculosis is primarily
systemic chemotherapy. Currently, the incidence of pulmonary
tuberculosis complicated by lung cancer is on the rise. These two
diseases exhibit similarities in clinical and radiographic
manifestations, posing challenges in differential diagnosis and
treatment. Thus, further research and exploration into the comprehensive
treatment of concurrent pulmonary tuberculosis and lung cancer are of
utmost importance.
Lung cancer and tuberculosis (TB) are common respiratory diseases,
stimulating both the immune and respiratory systems of the
patients[4,5]. Lung cancer, a malignant tumor, arises from the
abnormal proliferation of cells, while TB is a respiratory infectious
disease caused by the Mycobacterium tuberculosis. Many lung cancer
patients are diagnosed at intermediate to advanced stages, where
chemo-radiotherapy is one of the prevalent therapeutic strategies.
Radiotherapy is a localized treatment extensively used for patients at
these stages. Pulmonary radiotherapy may lead to hematologic toxicity,
pulmonary dysfunction, and liver function abnormalities.
Chemotherapeutic agents for lung cancer include taxanes, platinum drugs,
vinorelbine, and pemetrexed, while common anti-TB drugs include
streptomycin, isoniazid, rifampicin, ethambutol, pyrazinamide, and
levofloxacin. These medications carry side effects like hepatorenal
toxicity, cardiotoxicity, vascular toxicity, hematologic toxicity, and
gastrointestinal toxicity.
Consequently, the diagnosis and treatment of patients co-afflicted with
pulmonary tuberculosis and lung cancer present a complex challenge.
Determining an accurate diagnosis, minimizing the toxic side effects of
treatments, and effectively controlling both lung cancer and
tuberculosis merit our in-depth research.