Relationship between lung immune prognostic and the prognosis of locally advanced non-small cell lung cancer treated with radiochemotherapy
10.3760/cma.j.cn112271-20220119-00027
- VernacularTitle:肺免疫预后指数与局部晚期非小细胞肺癌放化疗预后的关系
- Author:
Yunhan WANG
1
;
Xiaoli ZHENG
;
Yanan SUN
;
Xiaohui WANG
;
Hui LUO
;
Chen CHENG
;
Yang YANG
;
Qinfu DAN
;
Ke YE
;
Hong GE
Author Information
1. 郑州大学附属肿瘤医院 河南省肿瘤医院放疗科，郑州 450008
- Keywords:
Locally advanced non-small cell lung cancer;
Radiochemotherapy;
Prognostic indicator;
Lung immune prognostic index
- From:
Chinese Journal of Radiological Medicine and Protection
2022;42(7):504-510
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between lung immune prognostic index (LIPI) and the prognosis of locally advanced non-small cell lung cancer (LA-NSCLC) treated with radiochemotherapy.Methods:A retrospective analysis was conducted for the clinical data of LA-NSCLC patients who received radiochemotherapy in the Affiliated Cancer Hospital of Zhengzhou University from 2013 to 2019. According to the hematologic test result of the derived neutrophil-to-lymphocyte ratio (dNLR) and the lactate dehydrogenase (LDH), the patients were divided into three groups according to their LIPI scores, namely the good-LIPI group with dNLR ≤ 3 and LDH ≤ upper limit of normal (ULN), moderate-LIPI group with dNLR >3 or LDH > ULN, and poor-LIPI group with dNLR >3 and LDH > ULN. Moreover, the overall survival (OS) and the progression-free survival (PFS) were calculated using the Kaplan-Meier method, the Log-rank test, and the Cox regression model.Results:A total of 238 patients were enrolled, and their median follow-up time was 37.1 months, median PFS 16.1 months, and median OS 30.6 months. The OS and PFS of the poor-LIPI group were significantly worse than those of the good- and moderate-LIPI groups ( χ2= 9.04, 2.88, P<0.05). The univariate analysis showed that the factors influencing OS included gender, pathological type, epidermal growth factor receptor (EGFR) mutations, and LIPI ( χ2=6.10, 13.66, 10.58, 9.04, P<0.05), and the PFS was only affected by the LIPI ( χ2=2.88, P = 0.03). Multivariate analysis suggested that EGFR mutations and LIPI were independent prognostic markers for OS ( HR = 1.31, 1.36; 95% CI: 1.03-1.67, 1.05-1.76; P<0.05). Conclusions:The LIPI is a potential prognostic indicator of radiochemotherapy in LA-NSCLC, and this result should be further confirmed by prospective studies.
