PET/CT Center, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
Department of Radiology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
Sci Rep. 2024 Sep 30;14(1):22632. doi: 10.1038/s41598-024-73080-w.
Non-small cell lung cancer (NSCLC) is a leading cause of cancer-related mortality, and the role of family cancer history in disease progression and treatment response remains underexplored. This study aims to investigate the influence of family tumor history on disease-free survival, tumor metabolism, and treatment response in NSCLC patients. A retrospective, single-center study of 414 NSCLC patients was conducted, with 101 patients having a family history of cancer (FHC). Disease-free survival (DFS), tumor glucose metabolism assessed by F-FDG PET/CT, and treatment response to chemoradiotherapy, targeted therapy, and immunotherapy were analyzed. Multivariate modeling was performed to improve prognostic prediction. Patients with FHC exhibited higher TNM staging, increased susceptibility to lymph node invasion, and elevated tumor glucose metabolism levels. Family history of cancer, particularly colorectal and lung cancer, was a significant risk factor for disease-free survival. Targeted therapy and immunotherapy significantly improved patient prognosis, while family history of cancer affected the efficacy of chemoradiotherapy but not targeted therapy or immunotherapy. Multivariate modeling combining FHC, treatment, and tumor metabolism levels yielded improved predictive performance. Our study highlights the importance of considering a patient's family history when assessing risk profiles and formulating treatment decisions for NSCLC patients. Further research is needed to understand the molecular mechanisms underlying these observed associations and to develop more effective treatment strategies for NSCLC patients with a cancer family history.
非小细胞肺癌（NSCLC）是癌症相关死亡的主要原因，家族癌症史在疾病进展和治疗反应中的作用仍未得到充分探索。本研究旨在探讨家族肿瘤史对 NSCLC 患者无病生存、肿瘤代谢和治疗反应的影响。对 414 例 NSCLC 患者进行了回顾性单中心研究，其中 101 例有家族癌症史（FHC）。分析无病生存（DFS）、F-FDG PET/CT 评估的肿瘤葡萄糖代谢以及化疗、靶向治疗和免疫治疗的反应。进行多变量建模以提高预后预测。FHC 患者的 TNM 分期更高，淋巴结侵犯的易感性增加，肿瘤葡萄糖代谢水平升高。家族癌症史，特别是结直肠癌和肺癌，是无病生存的显著危险因素。靶向治疗和免疫治疗显著改善了患者的预后，而家族癌症史影响了放化疗的疗效，但不影响靶向治疗或免疫治疗。结合 FHC、治疗和肿瘤代谢水平的多变量建模可提高预测性能。本研究强调了在评估 NSCLC 患者的风险概况和制定治疗决策时考虑患者家族史的重要性。需要进一步研究以了解这些观察到的关联的分子机制，并为具有家族癌症史的 NSCLC 患者开发更有效的治疗策略。
