Abstract
Platinum-based chemotherapy for advanced non-small cell lung cancer (NSCLC) is still considered the first choice, presenting a modest survival advantage. However, the patients eventually experience disease progression and require second-line therapy. While there are reliable predictors to identify patients receiving first-line chemotherapy, very little knowledge is available about the prognostic factors in patients who receive second-line treatments. The present study was therefore performed. We retrospectively reviewed 107 patients receiving second-line treatments from August 2002 to March 2012 in the Dicle University, School of Medicine, Department of Medical Oncology. Fourteen potential prognostic variables were chosen for analysis in this study. Univariate and multivariate analyses were conducted to identify prognostic factors associated with survival. The results of univariate analysis for overall survival (OS) were identified to have prognostic significance: performance status (PS), stage, response to first-line chemotherapy, response to second- line chemotherapy and number of metastasis. PS, diabetes mellitus (DM), response to first-line chemotherapy and response to second-line chemotherapy were identified to have prognostic significance for progression-free survival (PFS). Multivariate analysis showed that PS, response to first-line chemotherapy and response to second- line chemotherapy were considered independent prognostic factors for OS. Furthermore, PS and response to second-line chemotherapy were considered independent prognostic factors for PFS. In conclusion, PS, response to first and second-line chemotherapy were identified as important prognostic factors for OS in advanced NSCLC patients who were undergoing second-line palliative treatment. Furthermore, PS and response to second-line chemotherapy were considered independent prognostic factors for PFS. It may be concluded that these findings may facilitate pretreatment prediction of survival and can be used for selecting patients for the correct choice of treatment.
Highlights
Lung cancer is the most common among cause of cancer deaths in both men and women in world
)DFWRUV$QDO\]HG Fourteen potential prognostic variables were chosen on the basis of previously published clinical trials
The variables were divided to categories: age
Summary
Lung cancer is the most common among cause of cancer deaths in both men and women in world. NSCLC represent between 80% to 85% of all the diagnosed lung cancers cases (Boyle et al, 2005). At the time of diagnosis, In two-third of patients with lung cancer is diagnosed in locally advanced or metastatic disease. The median survival time for advanced disease is 5.8 to 12.6 months and the overall 5-year survival rate among this patient population is still less than 10% (Shepherd, 1993; Hotta et al, 2007). Platinum-based chemotherapy for advanced non-small cell lung cancer (NSCLC) is still FRQVLGHUHGWKHÀUVWFKRLFHSUHVHQWLQJDPRGHVWVXUYLYDODGYDQWDJH+RZHYHUWKHSDWLHQWVHYHQWXDOO\H[SHULHQFH GLVHDVH SURJUHVVLRQ DQG UHTXLUH VHFRQGOLQH WKHUDS\:KLOH WKHUH DUH UHOLDEOH SUHGLFWRUV WR LGHQWLI\ SDWLHQWV UHFHLYLQJ ÀUVWOLQH FKHPRWKHUDS\ YHU\ OLWWOH NQRZOHGJH LV DYDLODEOH DERXW WKH SURJQRVWLF IDFWRUV LQ SDWLHQWV ZKRUHFHLYHVHFRQGOLQHWUHDWPHQWV7KHSUHVHQWVWXG\ZDVWKHUHIRUHSHUIRUPHGMethods:HUHWURVSHFWLYHO\ UHYLHZHGSDWLHQWVUHFHLYLQJVHFRQGOLQHWUHDWPHQWVIURP$XJXVWWR0DUFKLQWKH'LFOH8QLYHUVLW\ 6FKRRO RI 0HGLFLQH 'HSDUWPHQW RI 0HGLFDO 2QFRORJ\ )RXUWHHQ SRWHQWLDO SURJQRVWLF YDULDEOHV ZHUH FKRVHQ IRUDQDO\VLVLQWKLVVWXG\8QLYDULDWHDQGPXOWLYDULDWHDQDO\VHVZHUHFRQGXFWHGWRLGHQWLI\SURJQRVWLFIDFWRUV DVVRFLDWHGZLWKVXUYLYDOResult7KHUHVXOWVRIXQLYDULDWHDQDO\VLVIRURYHUDOOVXUYLYDO 26 ZHUHLGHQWLÀHGWRKDYH SURJQRVWLFVLJQLÀFDQFHSHUIRUPDQFHVWDWXV 36 VWDJHUHVSRQVHWRÀUVWOLQHFKHPRWKHUDS\UHVSRQVHWRVHFRQG OLQHFKHPRWKHUDS\DQGQXPEHURIPHWDVWDVLV36GLDEHWHVPHOOLWXV '0 UHVSRQVHWRÀUVWOLQHFKHPRWKHUDS\ DQGUHVSRQVHWRVHFRQGOLQHFKHPRWKHUDS\ZHUHLGHQWLÀHGWRKDYHSURJQRVWLFVLJQLÀFDQFHIRUSURJUHVVLRQIUHH VXUYLYDO 3)6 0XOWLYDULDWHDQDO\VLVVKRZHGWKDW36UHVSRQVHWRÀUVWOLQHFKHPRWKHUDS\DQGUHVSRQVHWRVHFRQG OLQHFKHPRWKHUDS\ZHUHFRQVLGHUHGLQGHSHQGHQWSURJQRVWLFIDFWRUVIRU26)XUWKHUPRUH36DQGUHVSRQVHWR VHFRQGOLQHFKHPRWKHUDS\ZHUHFRQVLGHUHGLQGHSHQGHQWSURJQRVWLFIDFWRUVIRU3)6Conclusion,QFRQFOXVLRQ 36UHVSRQVHWRÀUVWDQGVHFRQGOLQHFKHPRWKHUDS\ZHUHLGHQWLÀHGDVLPSRUWDQWSURJQRVWLFIDFWRUVIRU26LQ DGYDQFHG16&/&SDWLHQWVZKRZHUHXQGHUJRLQJVHFRQGOLQHSDOOLDWLYHWUHDWPHQW)XUWKHUPRUH36DQGUHVSRQVH WRVHFRQGOLQHFKHPRWKHUDS\ZHUHFRQVLGHUHGLQGHSHQGHQWSURJQRVWLFIDFWRUVIRU3)6,WPD\EHFRQFOXGHGWKDW WKHVHÀQGLQJVPD\IDFLOLWDWHSUHWUHDWPHQWSUHGLFWLRQRIVXUYLYDODQGFDQEHXVHGIRUVHOHFWLQJSDWLHQWVIRUWKH FRUUHFWFKRLFHRIWUHDWPHQW.
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