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We collected patients' backgrounds, clinical and radiological features, laboratory data, treatment, and survival outcomes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>19,132 cancer patients received antineoplastic drug therapy during the study period, and 120 (0.62%) experienced severe DILD. The incidence of severe DILD in patients with thoracic cancer was highest among the patients included in this analysis (2.52% vs. 0.34% other cancers). Diffuse alveolar damage (DAD) pattern on CT was associated with higher mortality in patients with severe DILD compared with non-DAD pattern (hazard ratio [HR], 11.24; 95% CI, 4.82\u201326.2). Multivariate analysis revealed that the DAD pattern at diagnosis as severe DILD (HR, 3.59; 95% CI, 1.17\u201311.03), concurrent\/previous interstitial lung disease (HR, 3.20; 95% CI, 1.27\u20138.10), and ECOG performance status of 2\u20134 (HR, 3.81; 95% CI, 1.10\u201313.17) were independent risk factors for mortality in patients with severe DILD.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The frequency of severe DILD was highest in patients with thoracic cancer. The DAD pattern was associated with a poor outcome. From the perspective of DILD, special attention should be paid when administering antineoplastic agents to patients with thoracic cancer.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00432-022-03932-3","type":"journal-article","created":{"date-parts":[[2022,2,7]],"date-time":"2022-02-07T11:15:54Z","timestamp":1644232554000},"page":"1737-1746","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Incidence and prognostic factors in severe drug-induced interstitial lung disease caused by antineoplastic drug therapy in the real world"],"prefix":"10.1007","volume":"148","author":[{"given":"Sawako","family":"Kaku","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9090-801X","authenticated-orcid":false,"given":"Hidehito","family":"Horinouchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirokazu","family":"Watanabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kan","family":"Yonemori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuji","family":"Okusaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narikazu","family":"Boku","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoya","family":"Yamazaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Kawai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichiro","family":"Ohe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Kusumoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,2,7]]},"reference":[{"issue":"7","key":"3932_CR1","doi-asserted-by":"publisher","first-page":"1109","DOI":"10.2217\/fon.15.16","volume":"11","author":"O Abdel-Rahman","year":"2015","unstructured":"Abdel-Rahman O, Elhalawani H (2015) Risk of fatal pulmonary events in patients with advanced non-small-cell lung cancer treated with EGF receptor tyrosine kinase inhibitors: a comparative meta-analysis. 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Ltd, Bristol-Myers Squibb, Daiichi Sankyo Company, Limited, AstraZeneca K.K, AbbVie GK, and received honoraria from Eli Lilly Japan K.K., AstraZeneca K.K, Taiho Pharmaceutical Co., Ltd., Chugai Pharmaceutical Co., Ltd., MSD K.K., Novartis Pharma K.K., Takeda Pharmaceutical Co. Ltd., Kyowa Kirin Co., Ltd., Bristol-Myers Squibb. Dr. Yonemori had advisory roles of Chugai Pharmaceutical Co., Ltd., Ono Pharmaceutical Co. Ltd., and received honoraria from Takeda Pharmaceutical Co. Ltd., AstraZeneca K.K, Pfizer Inc., Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Eli Lilly Japan K.K. Dr. Okusaka's advisory roles were Taiho Pharmaceutical Co., Ltd., Daiichi Sankyo Company, Limited, Sumitomo Dainippon Pharma Co., Ltd., Bristol-Myers Squibb, AstraZeneca K.K., Eisai Co., Ltd., Nihon Servier. In addition, Dr.Okusaka received honoraria from ElmediX, Meiji Seika Pharma Co., Ltd., MSD K.K., AstraZeneca K.K, AbbVie GK, Eisai Co., Ltd., Ono Pharmaceutical Co. Ltd, Yakult Honsha Co.,Ltd., Shire plc, Daiichi Sankyo Company, Limited, Taiho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co. Ltd., Chugai Pharmaceutical Co., Ltd., Teijin Pharma Limited., Eli Lilly Japan K.K., Nippon Shinyaku Co., Ltd., Nihon Servier, Novartis Pharma K.K., Bayer Yakuhin, Ltd., Pfizer Inc., Mundipharma K.K., and received research grants from AstraZeneca K.K., Eisai Co., Ltd., Bristol-Myers Squibb, MSD K.K., Sumitomo Dainippon Pharma Co., Ltd. Dr. Boku received honoraria for lecture fees from Ono Pharmaceutical Co. Ltd., and Taiho Pharmaceutical Co., Ltd., and a research grant from Ono Pharmaceutical Co. Ltd. and Takeda Pharmaceutical Co. Ltd. Dr.Yamazaki reports personal fees and non-financial support from Ono Pharmaceutical Co. Ltd., Bristol-Myers Squibb, Novartis Pharma K.K., MSD K.K., individual fees from Merck Serono Co., Ltd., Takeda Pharmaceutical Co. Ltd., Chugai Pharmaceutical Co., Ltd. Dr. Kawai has received honoraria for lecture fees from Taiho Pharmaceutical Co., Ltd., Eli Lilly Japan K.K., Eisai Co., Ltd., <i>Takara Bio<\/i> Inc., Daiichi Sankyo, Bayer Yakuhin, Ltd., Kyowa Kirin Co., Ltd., Novartis Pharma K.K., and research expenses from Taiho Pharmaceutical Co., Ltd., Eli Lilly Japan K.K., Eisai Co., Ltd., Takara Bio Inc., and Daiichi Sankyo Company, Limited. Dr. Ohe had the advisory role of AstraZeneca K.K., Chugai Pharmaceutical Co., Ltd., Ono Pharmaceutical Co. Ltd., Bristol-Myers Squibb, Kyorin Pharmaceutical Co., Ltd., <i>Celltrion<\/i> Pharm Inc., Amgen Inc., and Nippon Kayaku Co., Ltd. In addition, Dr.Ohe received personal fees from AstraZeneca K.K., Chugai Pharmaceutical Co., Ltd., Eli Lilly Japan K.K., Ono Pharmaceutical Co. Ltd, Bristol-Myers Squibb, Boehringer Ingelheim, Bayer Yakuhin, Ltd., Pfizer Inc., MSD K.K., T Taiho Pharmaceutical Co., Ltd., Nippon Kayaku Co., Ltd., Kyowa Hakko Kirin Co., Ltd., and received research grants from AstraZeneca K.K., Chugai Pharmaceutical Co., Ltd., Lilly, Ono Pharmaceutical Co. Ltd, Bristol-Myers Squibb, Kyorin Pharmaceutical Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Pfizer Inc., Taiho Pharmaceutical Co., Ltd., Novartis K.K, Ignyta Inc., Takeda Pharmaceutical Co. Ltd., Kissei Pharmaceutical Co., Ltd., Daiichi Sankyo Company, Limited, Janssen Pharmaceutical K.K., Loxo Oncology. Dr. Kusumoto received honoraria for lecture fees from AstraZeneca K.K. and Daiichi Sankyo Company, Limited, and research grants from Canon medical systems corporation. The remaining authors declare no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"The Ethics Review Committee of the National Cancer Center Central Hospital approved this study protocol (Approval number: 2019-069).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"This manuscript contains no individual data.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}