Sınırlı evre küçük hücreli akciğer kanseri tanılı hastalarda eşzamanlı kemoradyoterapi öncesi sistemik immün inflamasyon indeksi’nin sağ kalıma etkisi

Year 2021, Volume: 14 Issue: 2, 186 - 198, 25.08.2021

Ahmet Küçük Şükran Eskici Öztep Eda Bengi Yılmaz Erkan Topkan

https://doi.org/10.26559/mersinsbd.842266

Abstract

Amaç: Birçok çalışmada, nötrofil (N), trombosit (T) ve lenfosit (L) bazlı sistemik immün inflamasyon indeksinin (Sİİ) çeşitli solid tümör tiplerin de sağ kalım sonuçlarını öngörebildiği gösterilmiştir. Daha önce sadece SE-KHAK hastalarından oluşan gruplarda eşzamanlı kemoradyoterapi (E-KRT) öncesi Sİİ’nin prognostik önemini araştıran çalışma olmaması nedeniyle Sİİ’nin bu hasta grubundaki prognostik önemini araştırmayı amaçladık. Yöntem: Ocak 2007-Aralık 2018 tarihleri arasında iki radyasyon onkolojisi merkezinde E-KRT ile tedavi edilen SE-KHAK hastalarını içeren retrospektif veriler analiz edilmiştir. Sİİ değerleri E-KRT'nin başlamasından önceki 7 gün içerisinde elde edilen toplam 139 hastanın periferik kan örneklerinde Sİİ = N×T/L formülü kullanılarak hesaplandı. Çalışma popülasyonunu farklı genel sağ kalım (GS) sonuçlarına sahip iki gruba ayırabilecek tedavi öncesi Sİİ’nin optimal eşik değeri receiver operating characteristic (ROC) analizi ile değerlendirildi. Genel sağ kalım (GS) Kaplan-Meier eğrileri kullanılarak bulunmuştur. Birincil sonlanım noktası Sİİ değeri ve GS sonuçları arasındaki ilişkiydi. Bulgular: Tedavi öncesi Sİİ’nin optimal eşik değeri 524 olarak bulunan hastalar iki gruba ayrılmıştır [Eğri altındaki alan (AAA): %68.1; duyarlılık: %68.6; özgüllük: %66.4]: Grup 1: Sİİ<524 (N=65) ve Grup 2: Sİİ≥524 (N=74). İki Sİİ grubu arasındaki Kaplan-Meier karşılaştırmaları Sİİ <524 grubunda Sİİ ≥524’ten anlamlı düzeyde daha uzun GS olduğunu (sırasıyla 34.6’ya karşı 12.5 ay; p<0.001) gösterdi. Benzer şekilde, 5- (%32'ye karşılık %8.9) ve 8 yıllık (%15'e karşılık %6) GS oranları da Sİİ<524 grubunda daha iyiydi. Çok değişkenli analizler sonucunda Sİİ’nin GS (p <0.001) için bağımsız bir prognostik faktör olduğu görülmüştür. Sonuç: Bu retrospektif analiz sonuçları tedavi öncesi Sİİ’nin, E-KRT ile tedavi edilen SE-KHAK hastaları için güçlü ve bağımsız bir prognostik biyobelirteç olduğunu göstermiştir.

Keywords

Küçük hücreli akciğer kanseri, Sistemik İmmün İnflamasyon İndeksi, Prognoz, Genel sağ kalım

Supporting Institution

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Project Number

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Thanks

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The effect of systemic immune inflammation index on survival before concurrent chemoradiotherapy in patients diagnosed with limited stage small cell lung cancer

Abstract

Aim: In many retrospective studies, it has been shown that neutrophil (N), platelet (P) and lymphocyte (L) based systemic immune inflammation index (Sİİ) can predict survival outcomes of various solid tumor types. For this purpose, we wanted to evaluate the prognostic importance of SII in LS-SCLC patients treated with concurrent chemoradiotherapy (C-CRT). Method: Retrospective data including LS-SCLC patients treated with C-CRT in two radiation oncology centers between January 2007 and December 2018 were analyzed. SII was calculated using the formula Sİİ = N × P / L in peripheral blood samples of a total of 139 patients in the last ≤ 7 days before the initiation of C-CRT. The optimal cut-off value of SII before treatment which can stratify the study population into two groups with different overall survival (OS) results, was evaluated by receiver operating characteristic (ROC) curve analysis. OS was estimated using Kaplan-Meier curves and Cox regression models. The primary endpoint was the relationship between the SII value and the OS results. Results: The optimal cut-off value of pre-treatment SII was found to be 594. [Area under the curve (AUC): 68.1%; sensitivity: 68.6%; specificity: 66.4%,]: Group 1: SII<524 (N=65) and Group 2: SII≥524 (N=74). Kaplan-Meier comparisons between the two SII groups showed that the SII<524 cohort had significantly longer OS than SII≥524 (34.6 vs. 12.5 months, respectively; p<0.001). Similarly, OS rates of 5 (32% vs. 8.9%) and 8-year (15% vs. 6%) were better in the SII<524 cohort. Results of multivariate analysis revealed the pretreatment SII as an independent prognostic factor for OS (p <0.001). Conclusion: These retrospective analysis results showed that pre-treatment SII is a strong prognostic biomarker for LS-SCLC patients treated with C-CRT.

Keywords

Small cell lung cancer, systemic immune inflammation index, prognosis, overall survival

Project Number

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