Prognostic Significance of C-Reactive Protein and Smoking in Patients with Advanced Non-small Cell Lung Cancer Treated with First-Line Palliative Chemotherapy
Prognostic Significance of C-Reactive Protein and Smoking in Patients with Advanced Non-small Cell Lung Cancer Treated with First-Line Palliative Chemotherapy
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DOI：
10.1097/jto.0b013e31819578c8
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发表时间：
2009-03-01
影响因子：
20.4
通讯作者：
Sorenson, Sverre
中科院分区：
文献类型：
--
作者：
Koch, Andrea;Fohlin, Helena;Sorenson, Sverre
假设：本研究的目的是分析C反应蛋白（CRP）和吸烟状况是否能为接受一线姑息化疗的晚期非小细胞肺癌（NSCLC）患者提供预后信息。一项回顾性、单机构研究，包括在2011年1月1日至2012年12月31日期间开始姑息一线化疗的所有IIIB/IV期NSCLC患者，世界卫生组织体能状态（PS）为0-2，2002年和2007年1月31日。审查了患者记录。考克斯的比例风险模型被用来确定预后factors.Results：208 - 9连续患者可评价。68%的人患有IV期疾病，67%的人患有PS 0或1。中位生存期为7.4个月。化疗开始时，206例患者（71%）CRP值升高（>= 10 mg/L）。144例患者（50%）为当前吸烟者。在单变量分析中，CRP水平升高的患者生存率较低（风险比[HR] = 1.67，95%置信区间[CI]，1.28-2.19，p < 0.001）。治疗开始时吸烟与生存期缩短相关（FIR 1.56，95% CI，1.22-1.98，p < 0.001）。曾吸烟者的生存期短于从不吸烟者（HR 1.80，95% CI，1.25-2.59，p = 0.001）。在多变量分析，阶段，PS，白蛋白，性别为协变量，在化疗开始时吸烟和CRP升高是独立的负预后因素survival.Conclusions：CRP和吸烟状态是独立的预后因素，晚期NSCLC患者接受姑息性一线化疗的生存，并提供额外的信息，以建立预后因素，如疾病的阶段和性能状态。
Hypothesis: The objective of the Study was to analyze if C-reactive protein (CRP) and smoking status provide prognostic information in patients with advanced non-small cell lung cancer (NSCLC) receiving palliative first-line chemotherapy.Methods: Retrospective, single-institutional study, comprising all patients with NSCLC stage IIIB/IV and World Health Organization performance status (PS) 0-2 who started palliative first-line chemotherapy between January 1, 2002, and January 3 1, 2007. Patient records were reviewed. Cox's proportional hazards model was used to identify prognostic factors.Results: Two hundred eight-nine consecutive patients were evaluable. Sixty-eight percent had stage IV disease and 67% had PS 0 or 1. Median survival was 7.4 months. At onset of chemotherapy, 206 patients (71%) had elevated CRP values (>= 10 mg/liter). One-hundred-forty-four patients (50%) were Current smokers. On Univariate analysis, patients with elevated CRP levels had inferior survival (hazard ratio [HR] = 1.67, 95% confidence interval [CI], 1.28-2.19, p < 0.001). Smoking at onset of treatment was associated with shorter survival (FIR 1.56, 95% Cl, 1.22-1.98, p < 0.001). Ever smokers had shorter Survival than never smokers (HR 1.80, 95% Cl, 1.25-2.59, p = 0.001). On multivariate analysis, with stage, PS, albumin, and gender as covariates, both smoking at start of chemotherapy and CRP elevation were independent negative prognostic factors for survival.Conclusions: CRP and smoking status are independent prognostic factors for survival in patients with advanced NSCLC receiving palliative first-line chemotherapy and provide additional information to established prognostic factors such as stage of disease and performance status.