Abukhalil Abdallah Damin, Mansour Khaldieh, Alhaj Wardah, Salah Inas, Sahoury Yousef, Al-Shami Ni'meh, Qawasmeh Mohammad
Birzeit University, Birzeit, Palestinian Territory.
J Egypt Natl Canc Inst. 2025 Jul 14;37(1):40. doi: 10.1186/s43046-025-00298-8.
Non-small cell lung cancer (NSCLC) is the third most common type of cancer in Palestine and has the highest mortality rate. Treatment approaches for NSCLC depend on many factors including stage, histology, molecular profile, and patient performance status.
This study explored the patient characteristics, molecular profiles, metastatic sites, prognosis, and treatment modalities.
This observational retrospective cohort study was conducted at multiple Palestinian hospitals. This study included patients diagnosed with metastatic NSCLC between 2016 and 2022. Patients with small-cell lung cancer (SCLC), newly diagnosed lung cancer, or incomplete information were excluded from the study. Patient data were obtained from the date of lung cancer diagnosis until death or loss to follow-up. Data were analyzed using IBM SPSS, and overall survival was calculated using the Kaplan-Meier estimate.
The study included 102 patients, 80.4% were male, 40.2% were current smokers, 42.2% were ex-smokers, and 17.6% were nonsmokers. (86.35%) of the patients were diagnosed with adenocarcinoma, and (77.5%) were diagnosed with stage IV NSCLC. Tumor recurrence was observed in 47.1% of patients after surgery. A total of 56.9% had PDL-1 expression ≥ 10%, and 45.1% had EGFR mutations. Fourteen (13.7%) received mono-chemotherapy with an estimated OS of (1219.200) days, 34 (33.3%) received mono-immunotherapy with an estimated OS of (720.152) days, and 54 (52.9%) received a combination of chemotherapy and immunotherapy with an OS of 2006.777 days. PFS (> 1 year) was higher in patients receiving combination therapy (58.3%). Myelosuppression, renal damage, and liver damage are some of the major side effects experienced by patients receiving either type of treatment.
The findings of this study provide vital information on tumor molecular mutation patterns and PDL expression for the adoption of appropriate measures in prevention and treatment strategies for NSCLC in Palestine. The majority of patients diagnosed with NSCLC were males with a history of smoking and were diagnosed at an advanced stage, which requires increased education, wariness of lung cancer, and smoking cessation programs at the national level.
非小细胞肺癌（NSCLC）是巴勒斯坦第三常见的癌症类型，且死亡率最高。NSCLC的治疗方法取决于许多因素，包括分期、组织学、分子特征和患者的体能状态。
本研究探讨了患者特征、分子特征、转移部位、预后和治疗方式。
这项观察性回顾性队列研究在多家巴勒斯坦医院进行。本研究纳入了2016年至2022年间被诊断为转移性NSCLC的患者。小细胞肺癌（SCLC）患者、新诊断的肺癌患者或信息不完整的患者被排除在研究之外。患者数据从肺癌诊断之日起获取，直至死亡或失访。使用IBM SPSS进行数据分析，并使用Kaplan-Meier估计法计算总生存期。
该研究纳入了102例患者，其中80.4%为男性，40.2%为当前吸烟者，42.2%为既往吸烟者，17.6%为非吸烟者。86.35%的患者被诊断为腺癌，77.5%的患者被诊断为IV期NSCLC。47.1%的患者术后出现肿瘤复发。共有56.9%的患者PDL-1表达≥10%，45.1%的患者存在EGFR突变。14例（13.7%）接受单药化疗，估计总生存期为（1219.200）天，34例（33.3%）接受单药免疫治疗，估计总生存期为（720.152）天，54例（52.9%）接受化疗与免疫治疗联合治疗，总生存期为2006.777天。接受联合治疗的患者无进展生存期（>1年）更高（58.3%）。骨髓抑制、肾损伤和肝损伤是接受任何一种治疗的患者所经历的一些主要副作用。
本研究结果为巴勒斯坦NSCLC预防和治疗策略中采取适当措施提供了关于肿瘤分子突变模式和PDL表达的重要信息。大多数被诊断为NSCLC的患者为有吸烟史的男性，且诊断时处于晚期，这需要在国家层面加强肺癌教育、提高警惕并开展戒烟项目。
