Endo Satoshi, Imai Hisao, Shiono Ayako, Hashimoto Kosuke, Miura Yu, Okazaki Shohei, Abe Takanori, Mouri Atsuto, Kaira Kyoichi, Masubuchi Ken, Masubuchi Takeshi, Kobayashi Kunihiko, Minato Koichi, Kato Shingo, Kagamu Hiroshi
Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Ota, Japan.
Department of Respiratory Medicine, International Medical Center, Saitama Medical University, Saitama, Japan.
Oncology. 2025;103(2):83-93. doi: 10.1159/000540651. Epub 2024 Aug 5.
Established biomarkers for predicting chemoradiotherapy efficacy for limited-disease small cell lung cancer (LD-SCLC) are lacking. The inflammation-based Glasgow Prognostic Score (GPS), comprising serum C-reactive protein (CRP) and albumin levels, can predict survival in advanced cancer. This study investigated whether metabolic and inflammatory markers, including the GPS, can predict the efficacy of chemoradiotherapy in patients with LD-SCLC.
We retrospectively analyzed 124 patients who underwent chemoradiotherapy for LD-SCLC at two institutions between April 2007 and June 2021, and assessed the prognostic significance of various metabolic and inflammatory markers. The GPS was calculated using the CRP and albumin concentrations, and categorized as follows: 0, CRP <1.0 mg/dL and albumin ≥3.5 mg/dL; 1, elevated CRP or decreased albumin; and 2, CRP ≥1.0 mg/dL and albumin<3.5 mg/dL. Differences in progression-free survival (PFS) and overall survival (OS) were examined using Kaplan-Meier curves and Cox proportional-hazard models.
The overall response rate was 95.1% (95% confidence interval [CI]: 89.6-97.9%). The median PFS and OS from chemoradiotherapy initiation were 12.6 (95% CI: 9.9-15.4) and 29.0 (95% CI: 24.8-45.5) months, respectively. The GPS demonstrated independent predictive ability for the effectiveness of chemoradiotherapy, wherein favorable scores (GPS 0-1) were significantly correlated with superior PFS and OS compared to unfavorable scores (GPS 2: PFS: 14.8 vs. 6.7 months, p = 0.0001; OS: 35.4 vs. 11.0 months, p < 0.0001).
This preliminary examination revealed that the GPS was significantly associated with PFS and OS in patients undergoing chemoradiotherapy for LD-SCLC, indicating its potential utility in assessing the therapeutic outcomes in LD-SCLC.
目前缺乏用于预测局限期小细胞肺癌（LD-SCLC）放化疗疗效的确立生物标志物。基于炎症的格拉斯哥预后评分（GPS），包括血清C反应蛋白（CRP）和白蛋白水平，可预测晚期癌症患者的生存情况。本研究调查了包括GPS在内的代谢和炎症标志物是否能预测LD-SCLC患者放化疗的疗效。
我们回顾性分析了2007年4月至2021年6月期间在两家机构接受LD-SCLC放化疗的124例患者，并评估了各种代谢和炎症标志物的预后意义。使用CRP和白蛋白浓度计算GPS，并分类如下：0，CRP<1.0mg/dL且白蛋白≥3.5mg/dL；1，CRP升高或白蛋白降低；2，CRP≥1.0mg/dL且白蛋白<3.5mg/dL。使用Kaplan-Meier曲线和Cox比例风险模型检查无进展生存期（PFS）和总生存期（OS）的差异。
总体缓解率为95.1%（95%置信区间[CI]：89.6-97.9%）。放化疗开始后的中位PFS和OS分别为12.6（95%CI：9.9-15.4）个月和29.0（95%CI：24.8-45.5）个月。GPS对放化疗疗效具有独立预测能力，其中良好评分（GPS 0-1）与较差评分（GPS 2）相比，PFS和OS明显更好（PFS：14.8对6.7个月，p=0.0001；OS：35.4对11.0个月，p<0.0001）。
这项初步检查显示，GPS与接受LD-SCLC放化疗患者的PFS和OS显著相关，表明其在评估LD-SCLC治疗结果方面具有潜在用途。
