Interstitial lung disease (ILD) prevalence and survival are increasing due to improvement in scientific research together with clinical complications typical of advanced disease. Lung cancer (LC) is described as a possible event occurring in lung parenchyma in the context of fibrotic abnormalities that worsen patients' prognosis. This growth of malignant cells on a fibrotic background has also been called scar-cinoma. For this reason, not only an early diagnosis but also personalized decisions on the best treatment approach should be considered for each patient in a multidisciplinary discussion, since in some cases chemotherapy or surgery could be detrimental for patients with pulmonary fibrosis. LC and lung fibrosis may share common pathogenetic mechanisms like an altered healing process in response to repeated tissue damage from environmental exposure in genetically susceptible individuals. Smoking history and air pollution together with mutations in telomere and surfactant protein genes lead to the production of cytokines and nitro derivatives in the microenvironment that facilitate the carcinomatous transformation during fibrogenesis. The evolution of LC therapy and the implementation of immunotherapy acting on targetable immune checkpoints have raised interest in evaluating ILD-LC actionable mutations. The main pathogenetic mechanisms, clinical presentations and treatment implications are presented in this review.

Keywords: chemotherapy; idiopathic pulmonary fibrosis; immunotherapy; interstitial lung diseases; lung cancer; lung cancer treatment; palliative care.

间质性肺病（ILD）的患病率和生存率由于科学研究的进步以及晚期疾病特有的临床并发症而增加。肺癌（LC）被描述为可能在纤维化异常背景下发生在肺实质中的事件，这会恶化患者的预后。恶性细胞在这种纤维化的背景上生长的现象也被称作瘢痕癌。因此，在多学科讨论中，不仅要考虑早期诊断，还要针对每位患者个性化地决定最佳治疗方案，因为在某些情况下，化疗或手术可能会对患有肺纤维化患者的病情产生不利影响。肺癌和肺纤维症可能具有共同的发病机制，例如在遗传易感个体反复受到环境暴露导致组织损伤后的修复过程异常。吸烟史、空气污染以及端粒基因和表面活性蛋白基因突变会促使微环境中细胞因子和亚硝基衍生物的生成，从而在纤维化过程中促进癌变转化。随着肺癌治疗的发展和针对可靶向免疫检查点的免疫疗法的实施，评估ILD-LC的可操作性突变引起了人们的兴趣。本文综述了主要的发病机制、临床表现及治疗意义。

关键词：化疗；特发性肺纤维化；免疫疗法；间质性肺病；肺癌；肺癌治疗；姑息治疗。