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.