Guo Jianping, Wang Lei, Wang Xiaoyan, Li Luo, Lü Yajuan, Wang Congcong, Hao Chong, Zhang Jiandong
Department of Radiotherapy, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan.
Department of Oncology, Maternal and Child Health Care Hospital of Zibo.
Medicine (Baltimore). 2020 Dec 4;99(49):e23321. doi: 10.1097/MD.0000000000023321.
The relationship between splenic volume and the outcome of chemoradiotherapy for lung cancer has rarely been studied or addressed. The purpose of our study was to investigate whether splenic volume was associated with prognosis in patients treated with chemoradiotherapy for advanced or locally advanced non-small cell lung cancer (NSCLC).A retrospective investigation was conducted. Finally, 202 patients met the criteria and were included in the study. All patients were divided into 2 groups according to the optimum cutoff value of splenic volume for overall survival (OS). The optimum cutoff value was identified by X-tile software, and the OS and disease-free survival (DFS) were compared between the 2 groups of patients. The impact of splenic volume and other clinical characteristics on OS and DFS was analyzed using the Kaplan-Meier method and Cox proportional hazards model. Clinical characteristics were compared using chi-square or Fisher exact tests.The median (range) of splenic volume was 156.03 (28.55-828.11) cm. The optimal cutoff value of splenic volume was 288.4 cm. For univariate analyses, high splenic volume was associated with decreased OS (P = .025) and DFS (P = .044). In multivariate analyses, splenic volume remained an independent predictor of OS as a binary dependent variable (P = .003).Excessive splenic volume was associated with decreased OS and DFS in patients with NSCLC treated with chemoradiotherapy. Splenic volume should be regarded as an independent prognostic factor for patients treated with chemoradiotherapy for advanced or locally advanced NSCLC.
脾体积与肺癌放化疗疗效之间的关系鲜有研究或涉及。本研究旨在探讨在接受放化疗的晚期或局部晚期非小细胞肺癌(NSCLC)患者中,脾体积是否与预后相关。
进行了一项回顾性研究。最终,202例患者符合标准并纳入研究。根据脾体积对总生存期(OS)的最佳截断值,将所有患者分为两组。通过X-tile软件确定最佳截断值,并比较两组患者的OS和无病生存期(DFS)。采用Kaplan-Meier法和Cox比例风险模型分析脾体积及其他临床特征对OS和DFS的影响。使用卡方检验或Fisher精确检验比较临床特征。
脾体积的中位数(范围)为156.03(28.55 - 828.11)cm³。脾体积的最佳截断值为288.4 cm³。单因素分析显示,高脾体积与OS降低(P = 0.025)和DFS降低(P = 0.044)相关。多因素分析中,脾体积作为二元因变量仍是OS的独立预测因素(P = 0.003)。
在接受放化疗的NSCLC患者中,脾体积过大与OS和DFS降低相关。脾体积应被视为晚期或局部晚期NSCLC患者放化疗的独立预后因素。