FREQUENCY AND PROGNOSTIC IMPORTANCE OF PRETREATMENT CLINICAL CHARACTERISTICS IN PATIENTS WITH ADVANCED NON SMALL-CELL LUNG-CANCER TREATED WITH COMBINATION CHEMOTHERAPY
FREQUENCY AND PROGNOSTIC IMPORTANCE OF PRETREATMENT CLINICAL CHARACTERISTICS IN PATIENTS WITH ADVANCED NON SMALL-CELL LUNG-CANCER TREATED WITH COMBINATION CHEMOTHERAPY
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DOI：
10.1200/jco.1986.4.11.1604
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发表时间：
1986-11-01
影响因子：
45.3
通讯作者：
GOLBEY, RB
中科院分区：
文献类型：
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作者：
OCONNELL, JP;KRIS, MG;GOLBEY, RB
为了确定目前正在接受治疗的III期非小细胞肺癌（NSCLC）患者的治疗前临床特征的频率和预后重要性，收集了自1978年以来接受高剂量（120 mg/m2）顺铂+长春花生物碱联合化疗方案的378例患者的数据。分析的变量包括年龄、性别、体重减轻、体能状态、组织学亚型、胸外转移的存在、转移器官部位的数量、肝脏、骨骼或脑部受累的存在、既往放疗或手术以及血清乳酸脱氢酶（LDH）。还研究了对化疗的主要反应对生存率的影响。使用多变量分析，发现以下与结果相关：初始体力状态，患者的体力状态为80%至100%，主要客观缓解率和生存率增加;骨转移，对缓解率和生存率有不利预测;血清LDH升高和男性性别，两者均与生存率和缓解持续时间缩短相关;以及存在两个或多个胸外转移器官部位，这与生存期较短相关。当将化疗的主要客观缓解纳入条件多变量分析时，它与较长的中位生存期密切相关。当比较相似患者中已完成研究的反应数据时，在设计未来的试验时，以及在选择晚期NSCLC个体患者的顺铂加长春花生物碱治疗时，该分析的信息可能是有用的。
To determine the frequency and prognostic importance of pretreatment clinical characteristics in patients currently undergoing treatment for stage III non-small-cell lung cancer (NSCLC), data were collected on 378 patients receiving high-dose (120 mg/m2) cisplatin plus vinca alkaloid combination chemotherapy regimens since 1978. Variables analyzed included age, sex, weight loss, performance status, histologic subtype, presence of extrathoracic metastases, number of metastatic organ sites, presence of liver, bone, or brain involvement, prior radiation or surgery, and serum lactate dehydrogenase (LDH). The effect of a major response to chemotherapy on survival was also investigated. Using multivariable analyses, the following were found to be associated with outcome: initial performance status, with patients having a performance status of 80% to 100% having an increased major objective response rate and survival; bone metastases, which were adversely predictive of responses rate and survival; elevated serum LDH and male sex, both of which were associated with shortened survival and remission duration; and the presence of two or more extrathoracic metastatic organ sites, which was associated with shorter survival. When major objective response with chemotherapy was included in a conditional multivariable analysis, it was strongly associated with longer median survival. Information from this analysis may be useful when comparing the response data of completed studies in similar patients, in designing future trials, and in the selection of cisplatin plus vinca alkaloid therapy for individual patients with advanced NSCLC.