Mohan A, Goyal A, Singh P, Singh S, Pathak A K, Bhutani M, Pandey R M, Guleria R
Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
Indian J Cancer. 2006 Apr-Jun;43(2):67-74. doi: 10.4103/0019-509x.25887.
Predictors of survival and response to treatment in patients with small cell lung cancer (SCLC) are ill-defined and unclear. In an attempt to assess the impact of common presenting symptoms and laboratory values on survival, we undertook this retrospective review of patients with SCLC. To our knowledge, there is no study on survival in SCLC patients from the Indian subcontinent.
Retrospective Cohort study.
All newly diagnosed small cell lung cancer cases from December 2001 through December 2004, were identified and clinical data on presenting symptoms and laboratory findings from their hospital records, noted. The influence of various pretreatment factors on survival was investigated using Kaplan-Meier plots and Cox multivariate regression model.
76 subjects were included (84% males, 91% smokers). 57% patients had five or more symptoms at presentation. Cumulative symptom burden was strongly associated with survival (P =0.02). Survival was also significantly related with Karnofsky performance status (KPS) (P =0.04), disease extent (P =0.03) and symptomatic response to treatment (P< 0.001). Patients with higher hemoglobin (P =0.02), serum sodium (P =0.04) and serum globulin (P =0.02), survived significantly longer. By multivariate regression analysis, hemoglobin, KPS and brain metastases, were significant predictors of survival (P =0.01, P =0.02, P< 0.01 respectively).
Cumulative symptom burden, KPS, disease extent and symptomatic assessment of improvement after treatment, are useful predictors of survival. This has important clinical implications, keeping in view, the infrastructure and cost involved in more objective tests like CT scan, for evaluation of disease extent and prognosis. These findings can provide a simple basis for predicting prognosis in small cell lung cancer, especially in developing countries like ours.
小细胞肺癌（SCLC）患者的生存预测因素及对治疗的反应尚不明确。为了评估常见症状和实验室检查结果对生存的影响，我们对SCLC患者进行了这项回顾性研究。据我们所知，尚无关于印度次大陆SCLC患者生存情况的研究。
回顾性队列研究。
确定2001年12月至2004年12月期间所有新诊断的小细胞肺癌病例，并记录其医院病历中关于症状和实验室检查结果的临床数据。使用Kaplan-Meier曲线和Cox多因素回归模型研究各种治疗前因素对生存的影响。
纳入76名受试者（84%为男性，91%为吸烟者）。57%的患者在就诊时有五种或更多症状。累积症状负担与生存密切相关（P =0.02）。生存还与卡诺夫斯基功能状态（KPS）（P =0.04）、疾病范围（P =0.03）和治疗后的症状反应（P<0.001）显著相关。血红蛋白水平较高（P =0.02）、血清钠水平较高（P =0.04）和血清球蛋白水平较高（P =0.02）的患者生存时间显著更长。通过多因素回归分析，血红蛋白、KPS和脑转移是生存的显著预测因素（分别为P =0.01、P =0.
