Sakin Abdullah, Yasar Nurgul, Arici Serdar, Demir Cumhur, Geredeli Caglayan, Aksaray Ferdi, Isik Selver, Cihan Sener
Department of Medical Oncology, Yuzuncu Yil University Medical School, Van, Turkey. Email:
Department of Medical Oncology, University of Health Sciences, Okmeydani Training and Research Hospital, Istanbul, Turkey.
Asian Pac J Cancer Prev. 2019 Jun 1;20(6):1879-1885. doi: 10.31557/APJCP.2019.20.6.1879.
Background: The aim of this study was to investigate the effect of platelet parameters before concurrent chemoradiotherapy (CCRT) on survival of patients with limited disease small cell lung cancer (LD-SCLC). Methods: This study consisted of patients who received CCRT due to LD-SCLC in the oncology clinic between 1997-2017. Examined platelet parameters included total platelet count (TPC), mean platelet volume, platelet distribution width, and platelet-lymphocyte ratio. The cut-off value for TPC was determined as 306x109/U (sensitivity: 62%, specificity: 75.5%), where patients below or equal to this level was classified as Group I, and those above as Group II. Results:The study included 90 patients whose mean age was 59 years (range: 42-83) and male ratio was 80.0% (n=72). Near three-fourths of patients (74.4%) were at clinical stage III. Among stage I-II patients, mOS was found as 126 months for Group I whereas it had not been reached in Group II (p=0.158). Stage III patients showed significantly lower mOS for Group 1 (16 [range: 14.1-17.8] months) compared to that in Group 2 (19.0 [range: 15.6-62.8] months; p=0.002). In multivariate analysis, Eastern Cooperative Oncology Group performance score (p=0.003), clinical stage (p<0.001), prophylactic cranial irradiation (p=0.004), and TPC (p=0.031) was determined as the most significant factors affecting survival. Conclusion: Our study suggests association of high baseline levels of TPC to improved survival in patients scheduled to undergo CCRT for LD-SCLC. Considering easiness and universal availability of TPC measurement, potential utilization of this biomarker may be promising to predict survival, albeit requiring validation by further well-designated prospective studies.
本研究旨在探讨同步放化疗（CCRT）前血小板参数对局限性小细胞肺癌（LD-SCLC）患者生存的影响。方法：本研究纳入了1997年至2017年间在肿瘤门诊因LD-SCLC接受CCRT的患者。检测的血小板参数包括血小板总数（TPC）、平均血小板体积、血小板分布宽度和血小板淋巴细胞比值。TPC的临界值确定为306×10⁹/U（敏感性：62%，特异性：75.5%），低于或等于该水平的患者分为I组，高于该水平的患者分为II组。结果：该研究纳入了90例患者，平均年龄59岁（范围：42 - 83岁），男性比例为80.0%（n = 72）。近四分之三的患者（74.4%）处于临床III期。在I - II期患者中，I组的中位总生存期（mOS）为126个月，而II组未达到（p = 0.158）。III期患者中，I组的mOS（16[范围：14.1 - 17.8]个月）显著低于II组（19.0[范围：15.6 - 62.8]个月；p = 0.002）。多因素分析中，东部肿瘤协作组体能状态评分（p = 0.003）、临床分期（p < 0.001）、预防性颅脑照射（p = 0.004）和TPC（p = 0.031）被确定为影响生存的最显著因素。结论：我们的研究表明，对于计划接受CCRT治疗的LD-SCLC患者，TPC基线水平高与生存改善相关。考虑到TPC测量的简便性和广泛可用性，尽管需要进一步精心设计的前瞻性研究进行验证，但该生物标志物的潜在应用可能有望预测生存。
