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Predicting risk of chemotherapy-induced severe neutropenia: A pooled analysis in individual patients data with advanced lung cancer.

预测化疗引起严重中性粒细胞减少的风险: 晚期肺癌患者个体数据的汇总分析。

  • 影响因子:4.52
  • DOI:10.1016/j.lungcan.2020.01.004
  • 作者列表:"Cao X","Ganti AK","Stinchcombe T","Wong ML","Ho JC","Shen C","Liu Y","Crawford J","Pang H","Wang X
  • 发表时间:2020-01-03
Abstract

OBJECTIVES:Neutropenia is associated with the risk of life-threatening infections, chemotherapy dose reductions and delays that may compromise outcomes. This analysis was conducted to develop a prediction model for chemotherapy-induced severe neutropenia in lung cancer. MATERIALS AND METHODS:Individual patient data from existing cooperative group phase II/III trials of stages III/IV non-small cell lung cancer or extensive small-cell lung cancer were included. The data were split into training and testing sets. In order to enhance the prediction accuracy and the reliability of the prediction model, lasso method was used for both variable selection and regularization on the training set. The selected variables was fit to a logistic model to obtain regression coefficients. The performance of the final prediction model was evaluated by the area under the ROC curve in both training and testing sets. RESULTS:The dataset was randomly separated into training [7606 (67 %) patients] and testing [3746 (33 %) patients] sets. The final model included: age (>65 years), gender (male), weight (kg), BMI, insurance status (yes/unknown), stage (IIIB/IV/ESSCLC), number of metastatic sites (1, 2 or ≥3), individual drugs (gemcitabine, taxanes), number of chemotherapy agents (2 or ≥3), planned use of growth factors, associated radiation therapy, previous therapy (chemotherapy, radiation, surgery), duration of planned treatment, pleural effusion (yes/unknown), performance status (1, ≥2) and presence of symptoms (yes/unknown). CONCLUSIONS:We have developed a relatively simple model with routinely available pre-treatment variables, to predict for neutropenia. This model should be independently validated prospectively.

摘要

目的: 中性粒细胞减少症与危及生命的感染、化疗剂量减少和可能损害预后的延迟风险相关。本分析旨在建立肺癌化疗引起的严重中性粒细胞减少的预测模型。 材料和方法: 纳入现有协作组 III/IV 期非小细胞肺癌或广泛小细胞肺癌 II/III 期试验的个体患者数据。数据被分成训练集和测试集。为了提高预测精度和预测模型的可靠性,采用 lasso 方法对训练集进行变量选择和正则化处理。将所选变量拟合到 logistic 模型以获得回归系数。通过训练集和测试集中 ROC 曲线下面积评价最终预测模型的性能。 结果: 将数据集随机分为训练 [7606 (67%) 患者] 和测试 [3746 (33%) 患者] 集。最终模型包括: 年龄 (> 65 岁) 、性别 (男性) 、体重 (kg) 、 BMI 、保险状况 (是/未知) 、分期 (IIIB/IV/ESSCLC) 、转移部位数目 (1 、 2 或 ≥ 3) 、单独用药 (吉西他滨、紫杉类) 、化疗药物数量 (2 个或 ≥ 3 个),计划使用生长因子、相关放射治疗、既往治疗 (化疗、放疗、手术) 、计划治疗持续时间、胸腔积液 (是/未知) 、性能状态 (1, ≥ 2) 和存在症状 (是/未知)。 结论: 我们开发了一个相对简单的模型,常规可用的治疗前变量,以预测中性粒细胞减少症。该模型应前瞻性独立验证。

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作者列表:["Esme H","Can A","Şehitogullari A"]

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影响因子:1.84
发表时间:2020-01-01
来源期刊:Oncology letters
DOI:10.3892/ol.2019.11149
作者列表:["Das SK","Huang YY","Li B","Yu XX","Xiao RH","Yang HF"]

METHODS::The aim of the present study was to compare the safety and efficacy of cryoablation (CA) and microwave ablation (MWA) as treatments for non-small cell lung cancer (NSCLC). Patients with stage IIIB or IV NSCLC treated with CA (n=45) or MWA (n=56) were enrolled in the present study. The primary endpoint was progression-free survival (PFS); the secondary endpoints included overall survival (OS) time and adverse events (AEs). The median PFS times between the two groups were not significantly different (P=0.36): CA, 10 months [95% confidence interval (CI), 7.5-12.4] vs. MWA, 11 months (95% CI, 9.5-12.4). The OS times between the two groups were also not significantly different (P=0.07): CA, 27.5 months (95% CI, 22.8-31.2 months) vs. MWA, 18 months (95% CI, 12.5-23.5). For larger tumors (>3 cm), patients treated with MWA had significantly longer median PFS (P=0.04; MWA, 10.5 months vs. CA, 7.0 months) and OS times (P=0.04; MWA, 24.5 months vs. CA, 14.5 months) compared patients treated with CA. However, for smaller tumors (≤3 cm), median PFS (P=0.79; MWA, 11.0 months vs. CA, 13.0 months) and OS times (P=0.39; MWA, 30.0 months vs. CA, 26.5 months) between the two groups did not differ significantly. The incidence rates of AEs were similar in the two groups (P>0.05). The number of applicators, tumor size and length of the lung traversed by applicators were associated with a higher risk of pneumothorax and intra-pulmonary hemorrhage in the two groups. Treatment with CA resulted in significantly less intraprocedural pain compared with treatment with MWA (P=0.001). Overall, the present study demonstrated that CA and MWA were comparably safe and effective procedures for the treatment of small tumors. However, treatment with MWA was superior compared with CA for the treatment of large tumors.

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影响因子:8.44
发表时间:2020-02-01
DOI:10.1016/j.annonc.2019.10.022
作者列表:["Mazieres J","Cropet C","Montané L","Barlesi F","Souquet PJ","Quantin X","Dubos-Arvis C","Otto J","Favier L","Avrillon V","Cadranel J","Moro-Sibilot D","Monnet I","Westeel V","Le Treut J","Brain E","Trédaniel J","Jaffro M","Collot S","Ferretti GR","Tiffon C","Mahier-Ait Oukhatar C","Blay JY"]

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