Abstract
OBJECTIVES:Lung cancer is the leading cause of cancer-related deaths worldwide. However, factors associated with the survival of patients with advanced non-small-cell lung cancer (NSCLC) who received only hospice care are largely unclear. In this study, we aimed to determine the prognostic factors correlated with survival in patients with advanced NSCLC who had undergone hospice care only.METHODS:A total of 102 patients with recurrent stage III/IV NSCLC after traditional treatment failure were investigated. Survival was measured from the date of enrollment to December 2019 or the time of death. Tumor tissues were collected, and DNA sequencing was performed to identify somatic mutations. Data on clinical factors of patients were collected and analyzed by univariate and multivariate analyses. Overall survival analysis was conducted using the Kaplan-Meier method.RESULTS:The 6-month, 1-year, and 2-year overall survival rates of the 102 patients with metastatic NSCLC were 17.65%, 3.92%, and 0.98%, respectively. The median overall survival of the 102 patients was 3.15 months. Tumor location in the peripheral lung, epidermal growth factor receptor (EGFR) inhibitor history, low tumor mutation load, adenocarcinoma, and poor performance status score were associated with prolonged survival compared with tumor location in the central lung, no EGFR inhibitor history, high tumor mutation load, squamous cell carcinoma, and good performance status score (p=0.045, p=0.003, p=0.045, p=0.021, and p=0.0003, respectively). CONCLUSIONS:EGFR inhibitor treatment history and tumor mutation load are risk factors for the overall survival of patients with stage III/IV NSCLC who have undergone only hospice care. These results provide a critical clinical basis for further study of nontraditional anti-tumor responses induced by EGFR inhibitors.
Highlights
Lung cancer is the leading cause of cancer-related deaths worldwide [1]
Much progress has been made toward advancing lung cancer treatments, such as epidermal growth factor receptor (EGFR) mutation-based targeted therapies [27]
The prognoses of latestage lung cancer remain poor, as almost all patients eventually develop drug resistance and disease progression within one or two years [28,29]. This is important in Asia, as approximately 40% of patients with Non-small-cell lung cancer (NSCLC) carry EGFR mutations [23]
Summary
Lung cancer is the leading cause of cancer-related deaths worldwide [1]. Non-small-cell lung cancer (NSCLC), which accounts for approximately 85% of all lung cancer cases, is often diagnosed at a late stage and has a poor prognosis [2]. Traditional treatment strategies, including surgical resection and chemotherapy, are most commonly used in lung cancer treatment. No potential conflict of interest was reported. Received for publication on July 19, 2020. Accepted for publication on December 2, 2020
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