Nomograms Predict Overall Survival for Patients with Small-Cell Lung Cancer Incorporating Pretreatment Peripheral Blood Markers
Nomograms Predict Overall Survival for Patients with Small-Cell Lung Cancer Incorporating Pretreatment Peripheral Blood Markers
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DOI：
10.1097/jto.0000000000000585
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发表时间：
2015-08-01
影响因子：
20.4
通讯作者：
Yang, Ping
中科院分区：
文献类型：
--
作者：
Xie, Dong;Marks, Randolph;Yang, Ping
背景资料：我们试图建立预后列线图，并确定新的预后因素在小细胞肺癌（SCLC）结合临床数据和外周血markets.Methods：我们分析了938例SCLC患者（555广泛期SCLC [ES-SCLC]和383局限期SCLC [LS-SCLC]）诊断1997年和2012年之间从一个单一的机构。我们研究了治疗前中性粒细胞与淋巴细胞比率、血小板与淋巴细胞比率、红细胞分布宽度、血红蛋白和其他临床病理因素的预后价值。考克斯比例风险模型确定多因素对总生存期（OS）的影响。开发了两个列线图来预测ES-SCLC的中位生存期和6个月和12个月OS，以及LS-SCLC的1年和2年OS。在ES-SCLC中，多变量考克斯模型将中性粒细胞/淋巴细胞比值和红细胞分布宽度确定为OS的重要预后因素，与年龄、东部肿瘤协作组体能评分、胸部放疗、化疗、肝转移、和转移部位的数量。在LS-SCLC中，重要的预后变量包括血小板与淋巴细胞比率、年龄、戒烟、胸部放疗、化疗、手术和预防性头颅放疗。结论：与现有模型相比，结合血液学指标的两种列线图能更准确地预测个体化小细胞肺癌的生存概率。
Background: We sought to build prognostic nomograms and identify novel prognostic factors in small-cell lung cancer (SCLC) incorporating both clinical data and peripheral blood markers.Methods: We analyzed 938 patients with SCLC (555 extensive stage SCLC [ES-SCLC] and 383 limited stage SCLC [LS-SCLC]) diagnosed between 1997 and 2012 from a single institution. We investigated the prognostic value of pretreatment neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, red cell distribution width, hemoglobin, and other clinicopathological factors. Cox proportional hazards models determined the effects of multiple factors on overall survival (OS). Two nomograms were developed to predict median survival and 6- and 12-month OS for ES-SCLC, and 1- and 2-year OS for LS-SCLC.Results: In ES-SCLC, the multivariate Cox model identified neutrophil to lymphocyte ratio and red cell distribution width as significant prognostic factors for OS independent of age, Eastern Cooperative Oncology Group performance score, chest radiation, chemotherapy, liver metastases, and numbers of metastatic sites. In LS-SCLC, significant prognostic variables included platelet to lymphocyte ratio, age, smoking cessation, chest radiation, chemotherapy, surgery, and prophylactic cranial irradiation. The two nomograms show good accuracy in predicting OS, with a concordance index of 0.73 in both ES- and LS-SCLC.Conclusion: The two nomograms incorporating hematological markers could more accurately predict individualized survival probability of SCLC than the existing models.