Objective  To systematically evaluate the incidence and influencing factors of pulmonary infections in chemotherapy patients.

Methods  CNKI, Wan Fang, VIP, CBM, PubMed, Embase, The Cochrane Library, and Web of Science were searched to collect the literature on influencing factors for lung infections in chemotherapy patients, with a timeframe from the inception of the database to July 10, 2025. Two investigators independently screened the literature according to the inclusion and exclusion criteria, and the Meta-analysis was performed using Stata 16.0 software.

Results  A total of 23 studies covering 8,800 patients were selected, with high literature quality scores. Meta- analysis showed that the incidence of combined pulmonary infection in patients with tumor chemotherapy was 24.4%, with 19.6% for lung cancer, 14.1% for esophageal cancer, and 44.6% for hematologic cancer. Age, age≥60 years, history of smoking, comorbid diabetes, comorbid chronic obstructive pulmonary disease (COPD), tumor location in the mid-thoracic region, late tumor staging, chemotherapy cycles≥2, combination of chemotherapeutic agents, presence of invasive operation, duration of radiotherapy≥30 days, neutrophil count reduction, hypoproteinemia, and severe anemia were independent risk factors for pulmonary infection in chemotherapy patients.

Conclusion  This systematic review identified 14 significant risk factors that are common clinical phenomena in chemotherapy patients. These factors should be monitored by clinical workers for early identification of high-risk individuals and enhanced assessment and care to reduce the incidence of pulmonary  infection.

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