Ito Yu, Zenke Yoshitaka, Sakai Tetsuya, Shibata Yuji, Izumi Hiroki, Nosaki Kaname, Umemura Shigeki, Matsumoto Shingo, Yoh Kiyotaka, Nakamura Masaki, Hojo Hidehiro, Izumo Takehiro, Goto Koichi
Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
Department of Respiratory Medicine, Japanese Red Cross Medical Center, Tokyo, Japan.
Future Oncol. 2025 Feb;21(4):473-481. doi: 10.1080/14796694.2024.2444858. Epub 2024 Dec 29.
This study aimed at developing a scoring system (EAST score) to predict recurrence after chemoradiotherapy in limited-stage small-cell lung cancer (LS-SCLC).
PATIENTS & METHODS: Treatment-naïve LS-SCLC patients receiving concurrent chemoradiotherapy (CCRT) ( = 234) or sequential chemoradiotherapy ( = 53) were retrospectively reviewed. Using data from CCRT population, clinical and radiological variables associated with disease progression were identified. Selected variables were assigned numerical scores based on their estimated hazard ratios (HRs), and the EAST score was established.
EAST score incorporated N3 disease and serum biomarkers (lactate dehydrogenase, pro-gastrin-releasing peptide, and cytokeratin-19 fragment). In the CCRT population, progression-free survival (PFS) was significantly shorter in the high-risk group (EAST score ≥ 2) than the low-risk group (EAST score ≤ 1) (median, 9.4 months vs. 20.6 months; HR [95% confidence interval (CI)], 2.09 [1.50-2.91]). As for the model performance, the 1- and 2-year area under the curve values for PFS were 0.68 and 0.65, respectively. Overall survival was also shorter in the high-risk group (HR [95% CI], 1.49 [1.02-2.16]). Similar trends were observed in the sequential chemoradiotherapy population (HR for PFS [95% CI], 2.43 [1.07-5.53]).
EAST score effectively predicts recurrence risk in LS-SCLC, demonstrating the necessity for developing new treatment strategies for high-risk patients.
本研究旨在开发一种评分系统（EAST评分），以预测局限期小细胞肺癌（LS-SCLC）放化疗后的复发情况。
回顾性分析初治的接受同步放化疗（CCRT）（n = 234）或序贯放化疗（n = 53）的LS-SCLC患者。利用CCRT人群的数据，确定与疾病进展相关的临床和影像学变量。根据选定变量的估计风险比（HRs）赋予其数值分数，从而建立EAST评分。
EAST评分纳入了N3期疾病和血清生物标志物（乳酸脱氢酶、胃泌素释放肽前体和细胞角蛋白19片段）。在CCRT人群中，高危组（EAST评分≥2）的无进展生存期（PFS）显著短于低危组（EAST评分≤1）（中位数，9.4个月对20.6个月；HR[95%置信区间（CI）]，2.09[1.50 - 2.91]）。至于模型性能，PFS的1年和2年曲线下面积值分别为0.68和0.65。高危组的总生存期也较短（HR[95%CI]，1.49[1.02 - 2.16]）。在序贯放化疗人群中观察到类似趋势（PFS的HR[95%CI]，2.43[1.07 - 5.53]）。
EAST评分能有效预测LS-SCLC的复发风险，表明有必要为高危患者制定新的治疗策略。
