Sato Yuki, Fujiwara Satoru, Shirakawa Chigusa, Hirabayashi Ryosuke, Nagata Kazuma, Nakagawa Atsushi, Tachikawa Ryo, Tomii Keisuke
Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan.
Department of Neurology, Kobe City Medical Center General Hospital, Kobe, Japan.
Thorac Cancer. 2024 Dec;15(34):2418-2427. doi: 10.1111/1759-7714.15472. Epub 2024 Oct 19.
Paraneoplastic neurological syndrome (PNS) is associated with small-cell lung cancer (SCLC). However, the frequency and characteristics of PNS and the efficacy of anticancer treatment for these patients have not been investigated in the Japanese/Asian population previously. Therefore, we aimed to better understand PNS by evaluating real-world data from patients with PNS complicated by SCLC.
Patients diagnosed with Stage II-IV SCLC at a single center between August 2007 and April 2021 were retrospectively analyzed. The primary outcome was the incidence of PNS. The secondary outcomes were the change in performance status (PS) after treatment commencement and outcomes following anticancer treatment, including objective response rate (ORR), progression-free survival (PFS), and overall survival (OS).
A total of 318 patients were evaluated; PNS was present in 2.8% (n = 9) of the overall population. All patients with PNS exhibited poor Eastern Cooperative Oncology Group PS (≥2); moreover, 78% of patients had a PS score of 3-4. An improvement in PS was observed in 56% (n = 5) of patients. Patients with PNS exhibited treatment efficacies similar to patients without PNS (ORR: 89% vs. 83%, p = 1.0; PFS: 7.6 vs. 5.7 months, p = 0.69; OS: not reached vs. 15.6 months, p = 0.23).
A total of 2.8% of patients had SCLC complicated by PNS, with poor PS observed. However, anticancer therapy led to an improvement in PS and comparable ORR, as well as PFS and OS similar to those observed in patients without PNS. Thus, anticancer therapy should be considered in patients with PNS.
副肿瘤性神经系统综合征（PNS）与小细胞肺癌（SCLC）相关。然而，此前日本/亚洲人群中PNS的发生率和特征以及这些患者的抗癌治疗疗效尚未得到研究。因此，我们旨在通过评估合并SCLC的PNS患者的真实世界数据，更好地了解PNS。
对2007年8月至2021年4月期间在单一中心诊断为II-IV期SCLC的患者进行回顾性分析。主要结局是PNS的发生率。次要结局是开始治疗后体能状态（PS）的变化以及抗癌治疗后的结局，包括客观缓解率（ORR）、无进展生存期（PFS）和总生存期（OS）。
共评估了318例患者；PNS在总体人群中的发生率为2.8%（n = 9）。所有PNS患者的东部肿瘤协作组PS均较差（≥2）；此外，78%的患者PS评分为3-4。56%（n = 5）的患者PS有所改善。PNS患者的治疗疗效与无PNS患者相似（ORR：89%对83%，p = 1.0；PFS：7.6个月对5.7个月，p = 0.69；OS：未达到对15.6个月，p = 0.23）。
共有2.8%的患者患有合并PNS的SCLC，且PS较差。然而，抗癌治疗使PS得到改善，ORR相当，PFS和OS与无PNS患者相似。因此，对于PNS患者应考虑进行抗癌治疗。
