Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland).
Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland).
Med Sci Monit. 2018 Nov 17;24:8264-8271. doi: 10.12659/MSM.911026.
BACKGROUND Although several complicated models have been built to evaluate the prognosis of NSCLC patients receiving chemotherapy, simple economic models are still needed to give a preliminary survival assessment of these patients. MATERIAL AND METHODS This study retrospectively assessed the clinical and biological parameters of 223 patients with advanced NSCLC. Univariate and multivariate analyses of overall survival (OS) and progression-free survival (PFS) for the parameters and the prognostic score were assessed. RESULTS Performance status (PS) score=1, smoking history, fibrinogenemia, thrombocytosis, increased lactate dehydrogenase (LDH) level, and anemia were independent predictors of poor prognosis in the univariate analysis of OS and were assessed in multivariate analysis. There was a significant difference in PS=1 (HR=2.134, p<0.0001), increased LDH level (HR=1.508, p=0.014), thrombocytosis (HR=1.547, p=0.012), and smoking history (HR=1.491, p=0.008), based on which the patients were classified into 3 risk groups: low risk (0-1 points), moderate risk (2 points), and high risk (3-5 points). At p values of <0.0001, the median OS was 565, 340, and 273 days and the median progression-free survival was 250, 209, and 135 days, respectively in these 3 risk groups. CONCLUSIONS We established a new prognostic score model using PS, LDH level, PLT count, and smoking history to predict the survival of patients receiving first-line chemotherapy for advanced NSCLC, which might be useful in clinical practice.
尽管已经建立了几种复杂的模型来评估接受化疗的 NSCLC 患者的预后,但仍需要简单的经济模型来初步评估这些患者的生存情况。
本研究回顾性评估了 223 例晚期 NSCLC 患者的临床和生物学参数。对参数和预后评分的总生存期(OS)和无进展生存期(PFS)进行了单因素和多因素分析。
体能状态(PS)评分=1、吸烟史、纤维蛋白原血症、血小板增多症、乳酸脱氢酶(LDH)水平升高和贫血是 OS 单因素分析中不良预后的独立预测因素,并在多因素分析中进行了评估。PS=1(HR=2.134,p<0.0001)、LDH 水平升高(HR=1.508,p=0.014)、血小板增多症(HR=1.547,p=0.012)和吸烟史(HR=1.491,p=0.008)之间存在显著差异,根据这些因素将患者分为 3 个风险组:低风险(0-1 分)、中风险(2 分)和高风险(3-5 分)。在 p 值<0.0001 时,这 3 个风险组的中位 OS 分别为 565、340 和 273 天,中位无进展生存期分别为 250、209 和 135 天。
我们使用 PS、LDH 水平、PLT 计数和吸烟史建立了一个新的预后评分模型,用于预测接受一线化疗的晚期 NSCLC 患者的生存情况,这在临床实践中可能有用。