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血小板计数降低对 EGFR-TKI 治疗的非小细胞肺癌患者预后的影响:一项回顾性研究。

Effects of reduced platelet count on the prognosis for patients with non-small cell lung cancer treated with EGFR-TKI: a retrospective study.

机构信息

Department of Geriatric Respiratory and Critical Care, Anhui Geriatric Institute, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, People's Republic of China.

Department of Pathology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, People's Republic of China.

出版信息

BMC Cancer. 2020 Nov 26;20(1):1152. doi: 10.1186/s12885-020-07650-2.

Abstract

BACKGROUND

Progressive lung cancer is associated with abnormal coagulation. Platelets play a vital part in evading immune surveillance and angiogenesis in the case of tumor metastasis. The study aimed to analyze the predictive and prognostic effects of platelet count on non-small cell lung cancer (NSCLC) patients treated with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs).

METHODS

This study retrospectively analyzed the prognostic effects of platelets on 52 NSCLC patients with epidermal growth factor receptor (EGFR) mutant following EGFR-TKI treatment. Related data, together with the progression-free survival (PFS) and overall survival (OS) were collected before and after 2 cycles of treatments (60 days).

RESULTS

The anti-EGFR treatment markedly reduced the platelet count in 33 (63.5%) patients after 2 cycles of treatment. Multivariate Cox analysis revealed that, the decreased platelet count was closely correlated with the longer OS (HR = 0.293; 95%CI: 0.107-0.799; p = 0.017). Besides, the median OS was 326 days in the decreased platelet count group and 241 days in the increased platelet count group (HR = 0.311; 95%CI: 0.118-0.818; P = 0.018), as obtained from the independent baseline platelet levels and other clinical features.

CONCLUSIONS

The platelet count may predict the prognosis for EGFR-TKI treatment without additional costs. Besides, changes in platelet count may serve as a meaningful parameter to establish the prognostic model for NSCLC patients receiving anti-EGFR targeted therapy.

摘要

背景

进展期肺癌与异常凝血有关。血小板在肿瘤转移时逃避免疫监视和血管生成中起着至关重要的作用。本研究旨在分析血小板计数对表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)治疗的非小细胞肺癌(NSCLC)患者的预测和预后影响。

方法

本研究回顾性分析了 52 例表皮生长因子受体(EGFR)突变的 NSCLC 患者在接受 EGFR-TKI 治疗后血小板计数的预后影响。收集了治疗前和治疗后 2 个周期(60 天)的相关数据,以及无进展生存期(PFS)和总生存期(OS)。

结果

在 2 个周期的治疗后,33 例(63.5%)患者的抗 EGFR 治疗显著降低了血小板计数。多变量 Cox 分析表明,血小板计数下降与较长的 OS 密切相关(HR=0.293;95%CI:0.107-0.799;p=0.017)。此外,血小板计数下降组的中位 OS 为 326 天,血小板计数升高组的中位 OS 为 241 天(HR=0.311;95%CI:0.118-0.818;P=0.018),这是从独立的基线血小板水平和其他临床特征得出的。

结论

血小板计数可能预测 EGFR-TKI 治疗的预后,而无需额外费用。此外,血小板计数的变化可以作为建立接受抗 EGFR 靶向治疗的 NSCLC 患者预后模型的有意义参数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bc8/7690006/b6267f33a1b4/12885_2020_7650_Fig1_HTML.jpg

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