Department of Thoracic Oncology and State Key Laboratory of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, 610041, PR China.
Jinhua Municipal Central Hospital, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Zhejiang, 321099, PR China.
Cancer Med. 2023 May;12(10):11375-11384. doi: 10.1002/cam4.5852. Epub 2023 Mar 31.
Lung cancer is frequently accompanied by interstitial lung disease (ILD), and the overall survival (OS) of patients with these comorbidities is poor. Thus, we developed a nomogram for the prediction of the OS of patients with advanced non-small cell lung cancer (NSCLC) and ILD.
Patients with wild-type gene advanced NSCLC with and without ILD who underwent chemotherapy between 2014 and 2019 were enrolled in the present study. The 0.5- and 1-year progression-free survival (PFS) and overall survival (OS) times of patients with and without ILD were determined using the Kaplan-Meier method. Cox regression was used to assess the prognostic value of clinical factors for patients with ILD. Based on the multivariate regression results, a nomogram for survival prediction was developed. The nomogram was validated using calibration curve.
Data from 155 patients with lung cancer and ILD and 118 matched patients with lung cancer alone who were receiving first-line chemotherapy were analyzed. The first-line chemotherapy regimens were paclitaxel + carboplatin, pemetrexed + carboplatin, gemcitabine + carboplatin, and other. The median PFS and OS were significantly shorter in patients with than in those without ILD (3.0 vs. 7.0 months [p < 0.001] and 7.0 vs. 15.0 months (p < 0.001), respectively). Multivariate analysis showed that the lymphocyte count (hazard ratio [HR] 2.38; 95% confidence interval [CI], 1.44-3.94; p = 0.01), partial pressure of oxygen (PaO ; HR, 1.37; 95% CI, 1.03-1.82; p = 0.03), and chemotherapy regimen were independently associated with prognosis. The nomogram showed good discriminatory ability [C-index = 0.69 (95% CI, 0.49-0.82)]. Calibration curves showed that predicted and actual prognoses were consistent.
This nomogram can aid the prediction of the OS of patients with advanced NSCLC and ILD.
肺癌常伴有间质性肺病（ILD），此类合并症患者的总体生存率（OS）较差。因此，我们开发了一个预测晚期非小细胞肺癌（NSCLC）合并ILD 患者 OS 的列线图。
本研究纳入了 2014 年至 2019 年期间接受化疗的野生型基因晚期 NSCLC 合并和不合并 ILD 的患者。采用 Kaplan-Meier 法确定患者有无 ILD 的 0.5 年和 1 年无进展生存率（PFS）和总生存率（OS）。采用 Cox 回归评估临床因素对合并 ILD 患者的预后价值。基于多变量回归结果，开发了一个生存预测列线图。采用校准曲线对该列线图进行验证。
共分析了 155 例肺癌合并 ILD 患者和 118 例接受一线化疗的单纯肺癌患者的数据。一线化疗方案为紫杉醇+卡铂、培美曲塞+卡铂、吉西他滨+卡铂和其他方案。与无 ILD 患者相比，ILD 患者的中位 PFS 和 OS 显著缩短（3.0 个月与 7.0 个月[P<0.001]和 7.0 个月与 15.0 个月[P<0.001]）。多变量分析显示，淋巴细胞计数（风险比[HR] 2.38；95%置信区间[CI]，1.44-3.94；P=0.01）、氧分压（PaO ）（HR，1.37；95%CI，1.03-1.82；P=0.03）和化疗方案与预后独立相关。该列线图显示出良好的判别能力[C 指数=0.69（95%CI，0.49-0.82）]。校准曲线显示，预测和实际预后一致。
该列线图可辅助预测晚期 NSCLC 合并 ILD 患者的 OS。
