Murali Aditya Navile, Radhakrishnan Venkatraman, Ganesan Trivadi S, Rajendranath Rejiv, Ganesan Prasanth, Selvaluxmy Ganesarajah, Swaminathan Rajaraman, Sundersingh Shirley, Krishnamurthy Arvind, Sagar Tenali Gnana
All authors: Cancer Institute (WIA), Adyar, Chennai, India.
J Glob Oncol. 2017 Jan 11;3(5):459-468. doi: 10.1200/JGO.2016.006676. eCollection 2017 Oct.
Lung cancer is the most common cause of cancer mortality in the world. There are limited studies on survival outcomes of lung cancer in developing countries such as India. This study analyzed the outcomes of patients with lung cancer who underwent treatment at Cancer Institute (WIA), Chennai, India, between 2006 and 2015 to determine survival outcomes and identify prognostic factors.
In all, 678 patients with lung cancer underwent treatment. Median age was 58 years, and 91% of patients had non-small-cell lung cancer (NSCLC). Testing for epidermal growth factor receptor mutation was performed in 132 of 347 patients and 61 (46%) were positive.
Median progression-free survival was 6.9 months and overall survival (OS) was 7.6 months for patients with NSCLC. Median progression-free survival was 6 months and OS was 7.2 months for patients with small-cell lung cancer. On multivariable analysis, the factors found to be significantly associated with inferior OS in NSCLC included nonadenocarcinoma histology, performance status more than 2, and stage. In small-cell lung cancer, younger age and earlier stage at presentation showed significantly better survival.
Our study highlights the challenges faced in treating lung cancer in India. Although median survival in advanced-stage lung cancer is still poor, strategies such as personalized medicine and use of second-line and maintenance chemotherapy may significantly improve the survival in patients with advanced-stage lung cancer in developing countries.
肺癌是全球癌症死亡的最常见原因。在印度等发展中国家,关于肺癌生存结果的研究有限。本研究分析了2006年至2015年间在印度钦奈癌症研究所(WIA)接受治疗的肺癌患者的结果,以确定生存结果并识别预后因素。
共有678例肺癌患者接受了治疗。中位年龄为58岁,91%的患者患有非小细胞肺癌(NSCLC)。在347例患者中的132例中进行了表皮生长因子受体突变检测,61例(46%)为阳性。
NSCLC患者的中位无进展生存期为6.9个月,总生存期(OS)为7.6个月。小细胞肺癌患者的中位无进展生存期为6个月,OS为7.2个月。多变量分析显示,NSCLC中与较差OS显著相关的因素包括非腺癌组织学、体能状态大于2以及分期。在小细胞肺癌中,较年轻的年龄和就诊时较早的分期显示出显著更好的生存率。
我们的研究突出了印度在肺癌治疗中面临的挑战。尽管晚期肺癌的中位生存期仍然较差,但个性化医疗以及使用二线和维持化疗等策略可能会显著提高发展中国家晚期肺癌患者的生存率。