Dept. of Oncology & Clinical Cancer Research Center, Aalborg University Hospital, Denmark; Dept. of Clinical Medicine, Faculty of Medicine, Aalborg University, Denmark.
Palliative Care Unit, Department of Oncology, Aarhus University Hospital, Denmark.
Cancer Treat Res Commun. 2021;27:100318. doi: 10.1016/j.ctarc.2021.100318. Epub 2021 Jan 22.
The study investigated the association of the relative dose-intensity (RDI) of cisplatin and timing of adjuvant platinum-based chemotherapy (APC) with survival for stage I-III non-small cell lung cancer (NSCLC) patients.
Real-life data of patients treated with APC (four cycles of cisplatin and vinorelbine) between 2007 and 2014 was included to analyse the association between disease-free survival (DFS) and overall survival (OS) with RDI (ratio of received to planned dose-intensity). High RDI was defined as cisplatin RDI of > 75% and low RDI ≤ 75%.
Out of 198 patients, 166 were eligible. Low RDI was administered to 72 (43%) patients. In multivariate analysis, those patients had a significantly higher risk of recurrence (HR: 1.87, 95%CI 1.13-3.09, p = 0.01) and death (HR: 1.91, 95%CI 1.32-3.23, p = 0.01) versus patients in the high RDI group. The risk of death was significantly higher in patients with PS 1 treated with low versus high RDI (HR: 2.72, 95%CI: 1.22-6.09, p = 0.014). The risk of recurrence was higher for patients with squamous cell carcinoma of low versus high RDI (HR: 3.82, 95%CI: 1.01-14.4, p = 0.048). No impact of delayed APC beyond six weeks from surgery on neither DFS (HR: 0.78, 95%CI: 0.46-1.33, p = 0.36) nor OS (HR 0.67, 95%CI: 0.40-1.15, p = 0.15) was observed.
Low cisplatin RDI ≤ 75% of APC, but not extended time from surgery to APC onset > six weeks, was associated with significantly shorter survival in NSCLC patients.
本研究旨在探讨顺铂的相对剂量强度（RDI）和辅助含铂化疗（APC）时机与 I-III 期非小细胞肺癌（NSCLC）患者生存的关系。
纳入了 2007 年至 2014 年间接受 APC（顺铂和长春瑞滨四周期）治疗的患者的真实数据，以分析无病生存期（DFS）和总生存期（OS）与 RDI（实际剂量强度与计划剂量强度之比）之间的关系。高 RDI 定义为顺铂 RDI ＞ 75%，低 RDI 为 ≤ 75%。
198 例患者中，166 例符合条件。72 例（43%）患者接受低 RDI 治疗。多因素分析显示，低 RDI 组患者复发风险显著升高（HR：1.87，95%CI 1.13-3.09，p = 0.01），死亡风险也显著升高（HR：1.91，95%CI 1.32-3.23，p = 0.01）。与高 RDI 组相比，PS 1 且接受低 RDI 治疗的患者死亡风险显著升高（HR：2.72，95%CI：1.22-6.09，p = 0.014）。与高 RDI 组相比，低 RDI 组患者中鳞癌患者的复发风险更高（HR：3.82，95%CI：1.01-14.4，p = 0.048）。术后 6 周以上开始 APC 治疗不会对 DFS（HR：0.78，95%CI：0.46-1.33，p = 0.36）或 OS（HR 0.67，95%CI：0.40-1.15，p = 0.15）产生影响。
低顺铂 RDI（≤75%）APC，而非 APC 开始时间（＞6 周）延迟，与 NSCLC 患者的生存时间显著缩短有关。
