Trikha Mehak, Noronha Vanita, Shah Minit, Patil Vijay, Menon Nandini, Singh Ajaykumar, Chandrani Pratik, Shetty Omshree, Kaushal Rajiv Kumar, Pai Trupti, Janu Amit, Purandare Nilendu, Prabhash Kumar
Department of Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai 400012, India.
Have contributed equally for this work.
Ecancermedicalscience. 2025 Mar 6;19:1867. doi: 10.3332/ecancer.2025.1867. eCollection 2025.
Lung cancer, particularly non-small-cell lung cancer (NSCLC), is a major global health issue. In India, the complexity of managing this disease is heightened by diverse demographics, varying healthcare access and evolving epidemiological trends influenced by factors such as smoking and advancements in diagnostics. This study explores cancer demographics and first-line palliative treatment options. We conducted a retrospective analysis of 3,414 advanced lung cancer patients planned for palliative systemic therapy at our centre between March 2000 and June 2017. The mean age of the cohort was 56.7 interquartile range (IQR: 21-88) years with a male predominance (71.9%). Histological subtypes included adenocarcinoma (82.9%), squamous cell carcinoma (13.6%) and others (3.5%). Intrathoracic metastases were seen in 40.7% and intrathoracic and extrathoracic in 37.7% of patients. The extrathoracic sites were skeletal (32.5%), liver (14.4%), brain (13.7%) and adrenal gland (9.0%). The baseline Eastern Cooperative Oncology Group Performance status was 0 (8.3%), 1 (58.7%), 2 (20.7%), 3 (11.7%) and 4 in 0.6% of the patients. Epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) positivity rates were lower in smokers. Most patients (92.4%) received the first-line systemic therapy, predominantly platinum-based doublets (67.1%). Tyrosine kinase inhibitors were given to 51.8% of EGFR+, 48% of ALK+ and 54.1% of mutation-negative cases. This study provides crucial insights into lung cancer demographics and treatment patterns at a single tertiary care centre in India, highlighting an increase in female lung cancer cases, steady smoking rates and improved access to genetic testing and targeted therapies.
肺癌，尤其是非小细胞肺癌（NSCLC），是一个重大的全球健康问题。在印度，由于人口结构多样、医疗服务可及性不同以及受吸烟和诊断技术进步等因素影响的不断变化的流行病学趋势，使得管理这种疾病的复杂性进一步增加。本研究探讨了癌症人口统计学特征和一线姑息治疗方案。我们对2000年3月至2017年6月期间在我们中心计划接受姑息性全身治疗的3414例晚期肺癌患者进行了回顾性分析。该队列的平均年龄为56.7岁（四分位间距[IQR]：21 - 88岁），男性占主导（71.9%）。组织学亚型包括腺癌（82.9%）、鳞状细胞癌（13.6%）和其他（3.5%）。40.7%的患者出现胸内转移，37.7%的患者出现胸内和胸外转移。胸外转移部位为骨骼（32.5%）、肝脏（14.4%）、脑（13.7%）和肾上腺（9.0%）。东部肿瘤协作组（ECOG）基线体能状态为0（8.3%）、1（58.7%）、2（20.7%）、3（11.7%），0.6%的患者为4。吸烟者的表皮生长因子受体（EGFR）和间变性淋巴瘤激酶（ALK）阳性率较低。大多数患者（92.4%）接受了一线全身治疗，主要是铂类双联方案（67.1%）。酪氨酸激酶抑制剂用于51.8%的EGFR阳性、48%的ALK阳性和54.1%的突变阴性病例。本研究为印度一家三级医疗中心的肺癌人口统计学特征和治疗模式提供了重要见解，突出了女性肺癌病例增加、吸烟率稳定以及基因检测和靶向治疗可及性改善的情况。
