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Blood Parameters Demonstrating a Significant Survival Impact in Patients With Locally Advanced NSCLC Undergoing Definitive Chemoradiotherapy.

血液参数对接受确定性放化疗的局部晚期 NSCLC 患者的生存影响显著。

  • 影响因子:1.90
  • DOI:10.21873/anticanres.14198
  • 作者列表:"Hoffmann M","Reitz D","Taugner J","Roengvoraphoj O","Käsmann L","Eze C","Karin M","Belka C","Manapov F
  • 发表时间:2020-04-01
Abstract

AIM:We investigated blood parameters in patients with inoperable stage III non-small cell lung cancer (NSCLC) to predict individual outcomes after definitive chemoradiotherapy (CRT). PATIENTS AND METHODS:Blood parameters of consecutive patients undergoing definitive CRT between 2010 and 2016 for inoperable stage III NSCLC before multimodal treatment and at first follow-up were measured and analyzed. RESULTS:Blood parameters from 99 patients were evaluated. Histologically, about 50% of patients had an adenocarcinoma. All patients received platinum-based sequential or concurrent CRT. The median total dose to the primary tumor was 60 (range=48-70) Gy. On multivariate analysis after adjustment for all co-founders, median overall survival for pre-treatment cutoffs were: lactate dehydrogenase (LDH) >250 U/l was 17 vs. 27 months [hazard ratio (HR)=2.05, 95% confidence intervaI (CI)=1.15-3.66; p=0.015], thrombocytosis >400×106/l: 11 vs. 23 months (HR=2.75, 95% CI=1.1-6.88; p=0.03), hypoalbuminemia <3.5 g/dl: 12 vs. 24 months (HR=2.42, 95% CI=1.21-4.84; p=0.013) and post-treatment neutrophilia >7×106/l: 12 vs. 27 months (HR=2.5, 95% CI=1.21-5.17; p=0.013). CONCLUSION:Pre-treatment elevated LDH, thrombocytosis, hypoalbuminemia and post-treatment neutrophilia were associated with significantly worse overall survival in patients with inoperable stage III NSCLC treated with CRT. Patients with both pre-therapeutic elevated LDH and hypoalbuminemia demonstrated a dismal prognosis despite completion of multimodal treatment.

摘要

目的: 我们研究了不能手术的 III 期非小细胞肺癌 (NSCLC) 患者的血液参数,以预测确定性放化疗 (CRT) 后的个体结局。 患者和方法: 测量并分析连续患者在多模式治疗前和首次随访前接受确定性 CRT (2010年) 和 2016 例不能手术的 III 期 NSCLC 的血液参数。 结果: 对 99 例患者的血液参数进行了评估。组织学上,约 50% 的患者为腺癌。所有患者均接受以铂类为基础的序贯或同期 CRT。原发肿瘤的中位总剂量为 60 (范围 = 48-70) Gy。在对所有共同创始人进行校正后的多变量分析中,治疗前的中位总生存期临界值为: 乳酸脱氢酶 (LDH) >250 U/l 为 17 vs。27 个月 [风险比 (HR)= 2.05,95% 置信 intervaI (CI)= 1.15-3.66; p = 0.015],血小板增多> 400 × 106/l: 11 vs. 23 个月 (HR = 2.75,95% CI = 1.1-6.88; p = 0.03),低白蛋白血症 <3.5g/dl: 12 vs. 24 个月 (HR = 2.42,95% CI = 1.21-4.84; p = 0.013) 和治疗后中性粒细胞减少> 7 × 106/l: 12 vs. 27 个月 (HR = 2.5,95% CI = 1.21-5.17; p = 0.013)。 结论: 在接受 CRT 治疗的不能手术的 III 期 NSCLC 患者中,治疗前 LDH 升高、血小板增多、低白蛋白血症和治疗后中性粒细胞增多与总生存期显著较差相关。尽管完成了多模式治疗,但治疗前 LDH 升高和低白蛋白血症的患者均表现出令人沮丧的预后。

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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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