Prognostic evaluation of nutritional indicators in patients with limited?stage small cell lung cancer
10.3760／cma.j.issn.0253?3766.2019.12.010
- VernacularTitle:营养指标对局限期小细胞肺癌患者预后的影响
- Author:
Jiaqi ZHANG
1
;
Youyou WANG
;
Kunpeng XU
;
Jing QI
;
Xin WANG
;
Liming XU
;
Ningbo LIU
;
Lujun ZHAO
;
Ping WANG
Author Information
1. 天津医科大学肿瘤医院放疗科 国家肿瘤临床医学研究中心 天津市肿瘤防治重点实验室 天津市恶性肿瘤临床医学研究中心300060
- Keywords:
Carcinoma,small cell lung;
Limited?stage;
Chemoradiotherapy;
Prognosis;
Prognostic nutritional index
- From:
Chinese Journal of Oncology
2019;41(12):937-942
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effect of nutritional status pre?and during chemoradiotherapy on the prognosis of patients with limited? stage small cell lung cancer ( LS?SCLC ). Methods We retrospectively collected medical records of 172 LS?SCLC patients undergoing concurrent chemoradiotherapy in our hospital from 2000 to 2014, with 126 males and 46 females. The data of complete blood count and hepatic and renal function were collected before initial treatment, before radiotherapy, 4 weeks during radiotherapy, and 1 month after complete of treatment. The prognostic nutritional index(PNI)was calculated. Kaplan?Meier method was used to calculate the survival rate. Log?rank test was performed used to compare the survival differences between groups. Multivariate prognostic analysis was performed using Cox regression model. Results The median overall survival ( OS) was 21 months, with median progression?free survival ( PFS) of 11 months. At the beginning of treatment, patients with pre?treatment PNI≥53 had significantly superior OS (median 37 vs 15 months, P＝0.001) and PFS (median 16 vs 10 months, P＝0.017). Patients with pre?treatment hemoglobin ≥140 g／L and ＜140 g／L had an median OS of 32 months and 17 months (P＝0.019), and median PFS of 16 months and 9 months ( P ＝ 0. 040 ), respectively. During chemoradiation, patients with elevated hemoglobin had similar median OS compared with those had decreased hemoglobin (27 vs 18 months, P＝0.063, but superior median PFS (15 vs 9 months, P＝0.017). Multivariate analysis revealed that prophylactic cranial irradiation,pre?treatment hemoglobin ≥140 g／L, and pretreatment PNI≥53 were independent predictors of OS and PFS in patients with LS?SCLC. Conclusion Pre? treatment nutritional status and the changes of nutritional status during chemoradiotherapy is significantly associated with the prognosis of patients with limited?stage small cell lung cancer. The patients with better pre?treatment nutritional status have a better prognosis.
