Ishibashi Yuki, Kobayashi Hiroshi, Ando Toshihiko, Okajima Kouichi, Oki Takahiro, Tsuda Yusuke, Shinoda Yusuke, Sawada Ryoko, Tanaka Sakae
Department of Orthopaedic Surgery, The University of Tokyo, Bunkyo-ku 113-8655, Tokyo, Japan.
Department of Rehabilitation, The Saitama Medical University, Morohongo 350-0495, Saitama, Japan.
World J Orthop. 2024 Dec 18;15(12):1155-1163. doi: 10.5312/wjo.v15.i12.1155.
Accurate data on the prognosis of bone metastases are necessary for appropriate treatment. Immune checkpoint inhibitors (ICIs) are widely used in the treatment of gene mutation-negative non-small cell lung cancer (GMN-NSCLC).
To investigate the prognostic factors in patients with bone metastases from GMN-NSCLC following ICI use.
This retrospective cohort study included 45 patients with GMN-NSCLC who were treated for bone metastases from 2017 to 2022 and received chemotherapy after diagnosis. Using Kaplan-Meier curves and Cox proportional hazards models, we evaluated the association between overall survival (OS) and clinical parameters, including serum biochemical concentrations and blood cell count.
Univariate analysis showed that Eastern Cooperative Oncology Group performance status ≤ 1 and the use of ICIs and bone-modifying agents after bone metastasis diagnosis were significantly associated with a favorable OS. Multivariate analysis revealed that ICI use after bone metastasis diagnosis was significantly associated with a favorable OS.
ICI use after bone metastasis diagnosis may be a favorable prognostic factor in patients with bone metastases of GMN-NSCLC. Consideration of ICI treatment for bone metastasis and GMN-NSCLC is warranted to establish a more accurate predictive nomogram for patients with bone metastasis.
准确的骨转移预后数据对于恰当治疗至关重要。免疫检查点抑制剂（ICIs）广泛应用于基因突变阴性的非小细胞肺癌（GMN - NSCLC）治疗。
探讨ICIs治疗后GMN - NSCLC骨转移患者的预后因素。
这项回顾性队列研究纳入了45例2017年至2022年期间接受骨转移治疗且诊断后接受化疗的GMN - NSCLC患者。使用Kaplan - Meier曲线和Cox比例风险模型，我们评估了总生存期（OS）与临床参数之间的关联，包括血清生化浓度和血细胞计数。
单因素分析显示，东部肿瘤协作组体能状态≤1以及骨转移诊断后使用ICIs和骨改良剂与良好的OS显著相关。多因素分析表明，骨转移诊断后使用ICIs与良好的OS显著相关。
骨转移诊断后使用ICIs可能是GMN - NSCLC骨转移患者的一个良好预后因素。考虑对骨转移和GMN - NSCLC患者进行ICIs治疗，以便为骨转移患者建立更准确的预测列线图。
