Li Ke, Qiu Lupeng, Zhao Yang, Sun Xiaohui, Shao Jiakang, He Chang, Qin Boyu, Jiao Shunchang
Medical School of Chinese PLA, Beijing, 100853, People's Republic of China.
Department of Oncology, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, People's Republic of China.
Int J Gen Med. 2024 May 7;17:1949-1965. doi: 10.2147/IJGM.S457329. eCollection 2024.
This study aims to investigate the process of small cell lung cancer (SCLC) patients from achieving optimal efficacy to experiencing disease progression until death. It examines the predictive value of the treatment response on progression free survival (PFS) and overall survival (OS) of SCLC patients.
We conducted a retrospective analysis on 136 SCLC patients diagnosed from 1992 to 2018. Important prognostic factors were identified to construct nomogram models. The predictive performance of the models was evaluated using the receiver operating characteristic curves and calibration curves. Survival differences between groups were compared using Kaplan-Meier survival curves. Subsequently, an independent cohort consisting of 106 SCLC patients diagnosed from 2014 to 2021 was used for validation.
We constructed two nomograms to predict first-line PFS (PFS1) and OS of SCLC. The area under the receiver operating characteristic curves for the PFS1 nomogram predicting PFS at 3-, 6-, and 12-months were 0.919 (95% CI: 0.867-0.970), 0.908 (95% CI: 0.860-0.956) and 0.878 (95% CI: 0.798-0.958), and for the OS nomogram predicting OS at 6-, 12-, and 24-months were 0.814 (95% CI: 0.736-0.892), 0.819 (95% CI: 0.749-0.889) and 0.809 (95% CI: 0.678-0.941), indicating those two models with a high discriminative ability. The calibration curves demonstrated the models had a high degree of consistency between predicted and observed values. According to the risk scores, patients were divided into high-risk and low-risk groups, showing a significant difference in survival rate. And these findings were validated in another independent validation cohort.
Based on the patients' treatment response after standardized treatment, we developed and validated two nomogram models to predict PFS1 and OS of SCLC. The models demonstrated good accuracy, reliability and clinical applicability by validating in an independent cohort.
本研究旨在调查小细胞肺癌(SCLC)患者从达到最佳疗效到疾病进展直至死亡的过程。研究其治疗反应对SCLC患者无进展生存期(PFS)和总生存期(OS)的预测价值。
我们对1992年至2018年诊断的136例SCLC患者进行了回顾性分析。确定重要的预后因素以构建列线图模型。使用受试者工作特征曲线和校准曲线评估模型的预测性能。使用Kaplan-Meier生存曲线比较组间生存差异。随后,使用由2014年至2021年诊断的106例SCLC患者组成的独立队列进行验证。
我们构建了两个列线图来预测SCLC的一线PFS(PFS1)和OS。预测3个月、6个月和12个月PFS的PFS1列线图的受试者工作特征曲线下面积分别为0.919(95%CI:0.867-0.970)、0.908(95%CI:0.860-0.956)和0.878(95%CI:0.798-0.958),预测6个月、12个月和24个月OS的OS列线图的受试者工作特征曲线下面积分别为0.814(95%CI:0.736-0.892)、0.819(95%CI:0.749-0.889)和0.809(95%CI:0.678-0.941),表明这两个模型具有较高的判别能力。校准曲线表明模型预测值与观察值之间具有高度一致性。根据风险评分,将患者分为高风险和低风险组,生存率存在显著差异。这些发现也在另一个独立验证队列中得到了验证。
基于标准化治疗后患者的治疗反应,我们开发并验证了两个列线图模型来预测SCLC的PFS1和OS。通过在独立队列中验证,这些模型显示出良好的准确性、可靠性和临床适用性。