Abstract：
Idiopathic pulmonary fibrosis is a poorly prognosed form of progressive interstitial pneumonia. Patients with IPF have a significantly increased risk of developing lung cancer, which further worsens the course of the disease. The most common histological types of LC among patients with IPF are squamous cell carcinoma and adenocarcinoma. Furthermore, all LC treatment modalities can lead to developing an acute IPF exacerbation. In this report, we present a rare case of coexistence of IPF and small cell lung cancer in a 76-year-old patient with chronic obstructive pulmonary disease, and a former smoker. For over 2 years, the patient was treated with an anti-fibrotic drug-pirfenidone, which slowed down the progression of IPF. Unfortunately, after being diagnosed with an active SCLC, the patient was excluded from further participation in the pirfenidone drug program. SCLC is characterized by high aggressiveness, rapid growth and high metastatic potential; therefore, it is necessary to apply antitumor treatment as soon as possible. The described patient was treated with carboplatin-etoposide chemotherapy. Early treatment tolerance was good and after two cycles of cytotoxic treatment, a partial response was present in CT. The presented case emphasizes the need for further research to determine the treatment regimens in patients with coexisting IPF and LC and the appropriateness of antifibrotic treatment in them. In addition, it can help to choose the treatment method for similar patients, indicating a combination of carboplatin and etoposide as an effective and, at the same time, relatively safes method in terms of the risk of IPF\'s exacerbation.
摘要：
特发性肺纤维化是进行性间质性肺炎的不良预后形式。IPF患者患肺癌的风险显着增加，这进一步恶化了疾病的进程。IPF患者中最常见的LC组织学类型是鳞状细胞癌和腺癌。此外，所有LC治疗方式均可导致IPF急性加重.在这份报告中,我们在一名76岁的慢性阻塞性肺疾病患者中发现了IPF和小细胞肺癌共存的罕见病例，一个前吸烟者。两年多来,患者接受了抗纤维化药物吡非尼酮治疗，这减缓了IPF的进展。不幸的是,在被诊断为活动性SCLC后，患者被排除在进一步参与吡非尼酮药物项目之外.SCLC的特点是高侵略性，快速生长和高转移潜力；因此，有必要尽快应用抗肿瘤治疗。所述患者接受卡铂-依托泊苷化疗。早期治疗耐受性良好，经过两个周期的细胞毒性治疗，CT出现部分缓解.该病例强调需要进一步研究以确定IPF和LC并存患者的治疗方案以及抗纤维化治疗的适当性。此外,它可以帮助选择类似患者的治疗方法，表明卡铂和依托泊苷的组合是有效的，同时,就IPF恶化的风险而言，方法相对安全。
