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体重指数对吉西他滨联合顺铂治疗肺鳞癌疗效及总生存的影响。

Influence of body mass index on the therapeutic efficacy of gemcitabine plus cisplatin and overall survival in lung squamous cell carcinoma.

机构信息

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Medical Oncology-I, Peking University Cancer Hospital and Institute, Beijing, China.

Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.

出版信息

Thorac Cancer. 2018 Feb;9(2):291-297. doi: 10.1111/1759-7714.12581. Epub 2018 Jan 10.

Abstract

BACKGROUND

Gemcitabine plus cisplatin (GP) is commonly used to treat lung squamous cell carcinoma (SCC); however, it is not clear which subgroup of lung SCC patients could benefit most from GP treatment. We explored the predictive factors in lung SCC patient cohorts.

METHODS

Seventy-eight lung SCC patients treated with a first-line GP regimen were enrolled in this retrospective cohort study. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Classification tree models were used to explore the risk factors for PFS and OS in these patients.

RESULTS

The median PFS and OS in SCC patients treated with a GP regimen were 6.0 and 13.6 months, respectively. Three terminal subgroups were formed for both PFS and OS. The subgroup with a body mass index (BMI) > 23.94 kg/m and aged ≤ 54.5 had the longest PFS (9.0 months); the subgroup with a BMI < 23.94  kg/m and aged ≤ 54.5 had the shortest PFS (4.05 months). Patients with an objective response (partial or complete response) to treatment had the longest OS (20.0 months), while patients with a BMI ≤ 26.92 kg/m and stable or progressive disease as the best response had the shortest OS (11.2 months).

CONCLUSIONS

BMI and age may be predictors of PFS in lung SCC patients who receive GP treatment. BMI and best response to GP treatment predicts OS in such patients. Patients' clinical pathological characteristics may be used to predict the therapeutic efficacy of chemotherapy and survival.

摘要

背景

吉西他滨联合顺铂(GP)方案常用于治疗肺鳞癌(SCC);然而,尚不清楚肺 SCC 患者中的哪个亚组最能从 GP 治疗中获益。我们探讨了肺 SCC 患者队列中的预测因素。

方法

本回顾性队列研究纳入了 78 例接受一线 GP 方案治疗的肺 SCC 患者。采用 Kaplan-Meier 法估计无进展生存期(PFS)和总生存期(OS)。采用分类树模型探讨这些患者 PFS 和 OS 的危险因素。

结果

接受 GP 方案治疗的 SCC 患者的中位 PFS 和 OS 分别为 6.0 个月和 13.6 个月。PFS 和 OS 均形成了 3 个终末亚组。BMI>23.94 kg/m2 且年龄≤54.5 岁的亚组 PFS 最长(9.0 个月);BMI<23.94 kg/m2 且年龄≤54.5 岁的亚组 PFS 最短(4.05 个月)。对治疗有客观缓解(部分或完全缓解)的患者 OS 最长(20.0 个月),而 BMI≤26.92 kg/m2 且疾病稳定或进展的患者最佳反应的 OS 最短(11.2 个月)。

结论

BMI 和年龄可能是接受 GP 治疗的肺 SCC 患者 PFS 的预测因素。BMI 和 GP 治疗的最佳反应预测了此类患者的 OS。患者的临床病理特征可用于预测化疗的疗效和生存。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aae6/5792736/796fd511c3f9/TCA-9-291-g001.jpg

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