古斯塔夫·鲁西免疫评分和皇家马斯登医院预后评分是广泛期小细胞肺癌的预后标志物。
Gustave Roussy Immune Score and Royal Marsden Hospital Prognostic Score Are Prognostic Markers for Extensive Disease of Small Cell Lung Cancer.
作者信息
Minami Seigo, Ihara Shouichi, Komuta Kiyoshi
机构信息
Department of Respiratory Medicine, Osaka Police Hospital, 10-31 Kitayama-cho, Tennoji-ku, Osaka 543-0035, Japan.
Department of Respiratory Medicine, Daini Osaka Police Hospital, 2-6-40 Karasugatsuji, Tennoji-ku, Osaka 543-8922, Japan.
出版信息
World J Oncol. 2020 Jun;11(3):98-105. doi: 10.14740/wjon1275. Epub 2020 May 14.
BACKGROUND
The Royal Marsden Hospital prognostic score (RMH score) and the Gustave Roussy immune score (GRIm-score) were developed in order to select more suitable patient for phase I trials. Lactate dehydrogenase (LDH) and serum albumin concentration are common risk factors to these two systems. As the third risk factor, the RMH score and the GRIm-score adopt number of metastatic sites and neutrophil-to-lymphocyte ratio (NLR), respectively. We aimed to investigate whether these two systems are also useful for extensive disease of small cell lung cancer (ED-SCLC).
METHODS
We retrospectively collected 128 patients who had initiated platinum-based chemotherapy at our hospital between September 2007 and March 2018. We divided our patients into low (score 0 - 1) and high (2 - 3) score groups, and compared overall survival (OS) and progression-free survival (PFS) between them. Multivariate Cox proportional hazard analyses found prognostic factors of survival times.
RESULTS
Regarding GRIm-score, OS was significantly shorter in high score group than in low score group (median 6.1 vs. 11.4 months, P < 0.01), while no significant difference was observed in PFS (median 4.7 vs. 5.0 months, P = 0.12). Both OS (median 6.9 vs. 12.4 months, P < 0.01) and PFS (median 4.4 vs. 5.4 months, P = 0.01) were significantly shorter in high RMH score group than in low group. Multivariate analyses detected both high GRIm-score (hazard ratio (HR) 1.80, 95% confidence interval (CI) 1.20 - 2.72, P < 0.01) and high RMH score (HR 1.93, 95% CI 1.27 - 2.92, P < 0.01) as independent worse prognostic factors of OS, and then only high RMH score (HR 1.53, 95% CI 1.04 - 2.25, P = 0.03) as independent worse prognostic factor of PFS.
CONCLUSIONS
Both RMH score and GRIm-score are useful as independent prognostic factors of OS in ED-SCLC. However, only RMH score is an independent prognostic factor of PFS.
背景
为了筛选出更适合参加Ⅰ期试验的患者，制定了皇家马斯登医院预后评分（RMH评分）和古斯塔夫·鲁西免疫评分（GRIm评分）。乳酸脱氢酶（LDH）和血清白蛋白浓度是这两个系统常见的风险因素。作为第三个风险因素，RMH评分和GRIm评分分别采用转移部位数量和中性粒细胞与淋巴细胞比值（NLR）。我们旨在研究这两个系统对于广泛期小细胞肺癌（ED-SCLC）是否也有用。
方法
我们回顾性收集了2007年9月至2018年3月期间在我院开始接受铂类化疗的128例患者。我们将患者分为低评分组（评分0-1）和高评分组（2-3），并比较两组之间的总生存期（OS）和无进展生存期（PFS）。多因素Cox比例风险分析确定生存时间的预后因素。
结果
关于GRIm评分，高评分组的OS显著短于低评分组（中位数6.1个月对11.4个月，P<0.01），而PFS无显著差异（中位数4.7个月对5.0个月，P=0.12）。高RMH评分组的OS（中位数6.9个月对12.4个月，P<0.01）和PFS（中位数4.4个月对5.4个月，P=0.01）均显著短于低评分组。多因素分析发现高GRIm评分（风险比（HR）1.80，95%置信区间（CI）1.20-2.72，P<0.01）和高RMH评分（HR 1.93，95%CI 1.27-2.92，P<0.01）均为OS的独立不良预后因素，而只有高RMH评分（HR 1.53，95%CI 1.04-2.25，P=0.03）为PFS的独立不良预后因素。
结论
RMH评分和GRIm评分均作为ED-SCLC患者OS的独立预后因素。然而，只有RMH评分是PFS的独立预后因素。
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