Shi Shiming, Ye Luxi, Zhao Qianqian, Hu Yong, Huang Yan, Chen Gang, Zeng Zhaochong, He Jian
Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai, China.
Jpn J Clin Oncol. 2019 Apr 1;49(4):367-372. doi: 10.1093/jjco/hyy205.
Lung cancer is the most common causes of cancer death worldwide and patients with non-small-cell lung cancer (NSCLC) have various prognosis. We conducted this study to identify the prognostic predictors and establish a prognostic index score (PIS) for patients with Stage I NSCLC after stereotactic body radiation therapy (SBRT).
A total of 131 consecutive patients with Stage I NSCLC who underwent SBRT in our institute were analyzed retrospectively. The Cox proportional hazards regression model was applied to identify the prognostic predictors. Time-dependent receiver operating characteristic analysis was performed to examine cutoff values for survival. The Kaplan-Meier method with log-rank test was used to compare survival curves.
Univariate analysis indicated that tumor location, maximum standardized uptake value (SUVmax), monocyte counts and platelet-to-lymphocyte ratio (PLR) were prognostic factors of overall survival (OS). SUVmax and PLR remained significant in multivariate analysis. Survival analysis indicated both high-SUVmax and PLR correlated with inferior OS and PFS. A PIS was constructed based on pretreatment SUVmax and PLR and a high PIS was also significantly associated with poor outcome.
The pretreatment SUVmax and PLR were independent prognostic factors of OS in patients with Stage I NSCLC after SBRT. PIS provides a convenient and accurate tool for predicting outcome of patients after SBRT.
肺癌是全球癌症死亡的最常见原因，非小细胞肺癌（NSCLC）患者的预后各不相同。我们开展这项研究以确定I期NSCLC患者在立体定向体部放射治疗（SBRT）后的预后预测因素，并建立预后指数评分（PIS）。
回顾性分析了在我院接受SBRT的131例连续的I期NSCLC患者。应用Cox比例风险回归模型确定预后预测因素。进行时间依赖性受试者工作特征分析以检验生存的临界值。采用Kaplan-Meier法和对数秩检验比较生存曲线。
单因素分析表明，肿瘤位置、最大标准化摄取值（SUVmax）、单核细胞计数和血小板与淋巴细胞比值（PLR）是总生存（OS）的预后因素。在多因素分析中，SUVmax和PLR仍然具有显著性。生存分析表明，高SUVmax和PLR均与较差的OS和无进展生存（PFS）相关。基于治疗前SUVmax和PLR构建了PIS，高PIS也与不良结局显著相关。
治疗前SUVmax和PLR是I期NSCLC患者SBRT后OS的独立预后因素。PIS为预测SBRT后患者的结局提供了一种方便且准确的工具。
