Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, China.
Thorac Cancer. 2021 Dec;12(23):3101-3109. doi: 10.1111/1759-7714.13581. Epub 2021 Nov 1.
The current study aimed to evaluate the serum pretreatment lactate dehydrogenase (LDH) and overall survival (OS) in small cell lung cancer (SCLC) patients who received first-line platinum-containing chemotherapy.
A total of 234 SCLC patients, who received first-line platinum-based chemotherapy between 2013 and 2018, were retrospectively analyzed. The data of hematological characteristics, age, gender, ECOG score, staging, metastatic site, smoking history, chemotherapy cycle, thoracic radiotherapy and hyponatremia were collected. Overall survival was calculated using the Kaplan-Meier method. The statistically significant factors in the univariate analysis were selected for the multivariate COX model analysis.
Age, ECOG score, stage, thoracic radiotherapy, hyponatremia, liver metastasis, brain metastasis, bone metastasis, LDH, NSE and neutrophil-to-lymphocyte ratio (NLR) were closely correlated to OS in the univariate analysis. Furthermore, the multivariate analysis revealed that age (<65 years), ECOG score (<2 points), limited-stage (LD), thoracic radiotherapy and LDH <215.70 U/L were the independent prognostic factors for survival. The median OS time was worse for patients with LDH ≥215.70 U/L. In the subgroup analysis, LDH ≥215.70 U/L was significant for survival in both limited and extensive disease. Patients who achieved CR + PR in the first-line treatment had lower initial LDH levels. It was found that the pretreatment LDH increased the incidence of patients with liver metastasis.
Positive independent prognostic factors for SCLC patients were age < 65 years old, ECOG score < 2 points, LD-SCLC, and pretreatment LDH <215.70 U/L. These factors may be useful for stratifying patients with SCLC for treatment approaches.
SIGNIFICANT FINDINGS OF THE STUDY: Age < 65 years old, ECOG score < 2 points, LD-SCLC, and pretreatment LDH <215.70 U/L are the positive independent prognostic factors for SCLC patients.
The current study provided more references for SCLC diagnosis and treatment and determined more factors for stratifying patients with SCLC for treatment approaches.
本研究旨在评估接受一线含铂化疗的小细胞肺癌（SCLC）患者的血清预处理乳酸脱氢酶（LDH）和总生存期（OS）。
回顾性分析 2013 年至 2018 年间接受一线铂类化疗的 234 例 SCLC 患者。收集血液学特征、年龄、性别、ECOG 评分、分期、转移部位、吸烟史、化疗周期、胸部放疗和低钠血症等数据。采用 Kaplan-Meier 法计算总生存期。单因素分析中具有统计学意义的因素被选择用于多因素 COX 模型分析。
年龄、ECOG 评分、分期、胸部放疗、低钠血症、肝转移、脑转移、骨转移、LDH、NSE 和中性粒细胞与淋巴细胞比值（NLR）在单因素分析中与 OS 密切相关。此外，多因素分析显示，年龄（<65 岁）、ECOG 评分（<2 分）、局限期（LD）、胸部放疗和 LDH<215.70 U/L 是生存的独立预后因素。LDH≥215.70 U/L 的患者中位 OS 时间更差。在亚组分析中，LDH≥215.70 U/L 在局限性和广泛性疾病中均与生存相关。一线治疗中达到 CR+PR 的患者初始 LDH 水平较低。研究发现，预处理 LDH 增加了肝转移患者的发生率。
SCLC 患者的阳性独立预后因素为年龄<65 岁、ECOG 评分<2 分、LD-SCLC 和预处理 LDH<215.70 U/L。这些因素可能有助于对 SCLC 患者进行治疗方法的分层。
本研究的重要发现：年龄<65 岁、ECOG 评分<2 分、LD-SCLC 和预处理 LDH<215.70 U/L 是 SCLC 患者的阳性独立预后因素。
本研究为 SCLC 的诊断和治疗提供了更多参考，并确定了更多用于分层患者治疗方法的因素。
