Prognostic role of pre-chemotherapy platelet counts in patients with non-small cell lung cancer treated with first-line chemotherapy at IRD SMS medical college Jaipur

Abstract

Introduction: Lung cancer remains the most common cause of cancer death worldwide. The difference in outcome among patients with same clinical stage of disease suggests that advanced non-small cell lung carcinoma (NSCLC) is heterogeneous disease. The patient's heterogeneity is leading to need for identification of prognostic factors for survival. The analysis of these factors will be helpful in advising individuals, choosing treatment, understanding disease and optimising results of chemotherapy. Aim: To study the relationship between pre-chemotherapy platelet count and tumour response in NSCLC patients. Methodology: This was a hospital-based descriptive study. All patients are cytological and/or histological confirmed NSCLC. We divided patients in two group, patients with normal platelet count and patients with thrombocytosis. Platinum-based chemotherapy was started to patients after pre-chemotherapeutic evaluation. After 3rd and 6th cycles of chemotherapy, patients were evaluated for radiological response as per RECIST criteria. Results: Total 70 patients were enrolled in the study. Those patients who showed progressive disease after 3rd cycle and 6th cycle had higher mean platelet count (4.33 ± 1.21 lakh and 4.14 ± 0.30 lakh, respectively) compared to those patients who showed complete response and partial response. In this study, 78.57% patients with thromboytosis died, while 35.71% patients with normal platelet count died after 6 months of follow-up. Conclusions: The study suggests that pre-chemotherapy thrombocytosis can be considered as a potential negative independent factor for survival and tumour response in patients of NSCLC. Awareness of association between prognostic factor including pre-chemotherapy platelet count and NSCLC may benefit disease outcome.