Abstract
Aim: The aim of this study was to investigate prognostic factors for survival in patients with advanced NSCLC who receiving second-line chemotherapy. Methods: We retrospectively reviewed data of 116 patients with NSCLC receiving second-line treatments from October 2010 to December 2012 in Clinic for Lung Diseases of Clinical center Nis, Department for Pulmonary Oncology. Thirteen potential prognostic factors were chosen for analysis. Univariate analysis was conducted to identify prognostic factors associated with progression free survival and overall survival. Multivariate analysis included the prognostic significance factors in univariate analysis. Results: The univariate analysis for progression free survival (PFS) and overall survival (OS) was identified to have prognostic significance: performance status, smoking, weight loss, comorbidity, number of meta localization, first-line chemotherapy regimen and response to first-line chemotherapy. Nevertheless, multivariate Cox prortional hazard regression analysis showed that performance status (PFS: p = 0.000, OS: p = 0.000) weight loss ≥ 5% (PFS: p = 0.000, OS: p = 0.002), comorbidity (PFS: p = 0.001, OS: p = 0.012) and four places of meta localization (PFS: p = 0.021, OS: p = 0.021) were considered independent prognostic factors for both, progression free survival and overall survival. Conclusion: Performance status, weight loss ≥ 5%, comorbidity and higher number of meta localization were identified as prognostic factors for survival in advanced NSCLC patients receiving second-line chemotherapy treatment. These findings may help pretreatment prediction of survival and may facilitate in the future integration new agents into second-line treatment.
Highlights
Lung cancer is the leading cause of cancer-related mortality in both men and women in world and it is estimated that more patients will die of lung cancer than of breast, colon, and prostate cancer combined [1].Non-small cell lung cancer (NSCLC) represents between 80% to 85% of all the diagnosed lung cancers cases [2]
The variables were divided to categories: 1) age (
While the prognostic factors associated with improved survival with first-line therapy have been extensively studied, less information exists about the prognostic factors in second-line therapy
Summary
Lung cancer is the leading cause of cancer-related mortality in both men and women in world and it is estimated that more patients will die of lung cancer than of breast, colon, and prostate cancer combined [1].Non-small cell lung cancer (NSCLC) represents between 80% to 85% of all the diagnosed lung cancers cases [2]. For approximately two thirds of NSCLC patients who present with advanced-stage disease, generally defined as stage IIIB or stage IV disease, the primary treatment is chemotherapy [3]. At the time of diagnosis, two-third of patients with lung cancer are diagnosed with locally advanced or metastatic disease. 15.6% of all lung cancer patients are alive 5 years or more after diagnosis [4]. A significant percentage of patients who present with local or locoregional disease will relapse with metastatic disease. For patients who have a good performance status (PS), chemotherapy has been shown to produce longer survival, palliate disease-related symptoms, and produce a better quality of life than with best supportive care (BSC) [3]. Patients who have a good performance status benefit from platinum based regimen chemotherapy [6,7]. Phase III randomized trials have shown that many of the platinumdoublet combination yield similar objective response
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