DEFİNİTİF KEMORADYOTERAPİ İLE TEDAVİ EDİLEN AKCİĞER KANSERİ HASTALARINDA YENİ İNFLAMATUAR PROGNOSTİK BELİRTEÇLER

Yıl 2022, , 646 - 651, 31.12.2022

Alper Yeniçeri Ahmet Gulmez , Hakan Harputluoglu

https://doi.org/10.54005/geneltip.1107790

Öz

Primer akciğer kanseri dünya çapında en sık görülen kanserdir ve giderek yaygınlaşan bir sorundur. Bu çalışmanın birincil sonlanım noktası; radyoterapi dozu ve nötrofil-lenfosit oranının (NLR) genel sağ kalım (OS) ve progresyonsuz sağ kalım (PFS) üzerindeki etkisini araştırmaktır. Tanı anında evre III A ve evre III B olan, cerrahi tedavi olmayan ve definitif kemoradyoterapi alan 99 hastayı retrospektif olarak inceledik. Hastalara ait cinsiyet, yaş, ECOG durumu, tümör yerleşimi, patolojik alt tip, radyoterapi dozu, kemoterapi tipi, nötrofil/lenfosit oranı (NLR), bazı biyokimyasal parametreler ve PFS ve OS gibi veriler hastaların detaylı dosya taraması yapılarak çalışmaya dahil edildi. Radyoterapi cut-off değeri 60 Gray olarak kabul edildi. OS, 60 Gray ve üzeri dozlarda radyoterapi alan hastalarda istatistiksel anlamlı olacak şekilde daha iyiydi. Radyoterapi dozu 60 Gy'nin altında olan hastalar ve 60 Gray'in üzerinde olan hastalar iki grupta değerlendirildiğinde genel sağ kalım sırasıyla 8.569 ± 1.404 / ay ve 14.326 ± 1.209 / ay idi. (p <0.05). Hastaları NLR'ye göre değerlendirdiğimizde; tanı anında NLR 4'ün altındaki hastaların genel sağ kalımının istatistiksel olarak anlamlı derecede daha iyi olduğu gözlendi. NLO <4.0 ve NLO> 4 olan hastaların genel sağ kalımları sırasıyla 14.32 ± 1.30/ay ve 10.54 ± 1.16/ay idi. (p <0.05)

Anahtar Kelimeler

Akciğer Kanseri, Definitif Kemoradyoterapi, Prognostik Belirteçler

Destekleyen Kurum

Herhangi bir kurum yada kuruluştan destek alınmadı.

Proje Numarası

2018/21-11

Teşekkür

Makalemi degerlendırmeye aldıgınız için çok teşekkür ederim.

Novel Inflammatory Prognostic Markers in Lung Cancer Patients Treated with Definitive Chemoradiotherapy

Öz

Primary lung cancer is the most common cancer worldwide and is an increasingly common problem. The primary endpoint of this study was; to investigate the effect of radiotherapy dose and neutrophil-lymphocyte ratio (NLR) on overall survival (OS) and progression-free survival (PFS). We retrospectively examined 99 patients who were stage III A and stage III B at the time of diagnosis, who did not receive surgical treatment, and who received definitive chemoradiotherapy. Data of patients such as sex, age, ECOG status, tumor location, pathological subtype, radiotherapy dose, type of chemotherapy, neutrophil/lymphocyte ratio (NLR), and some biochemical parameters and PFS and OS were included in the study by scanning the patient's files. The radiotherapy cut-off value was accepted as 60 Gray. OS was statistically better in patients who received radiotherapy at doses of 60 Gray and above. When the patients with radiotherapy dose less than 60 Gy and patients with more than 60 Gray were evaluated in two groups, the overall survival was 8,569 ± 1,404 / month and 14,326 ± 1,209 / month, respectively. (p <0.05). When we evaluate the patients based on NLR; It was observed that the overall survival of patients below NLR 4 at the time of diagnosis was statistically significantly better. The overall survival of patients with NLR <4.0 and NLR> 4 was 14.32 ± 1.30 / month and 10.54 ± 1.16 / month, respectively. (p <0.05)

Anahtar Kelimeler

Lung Cancer, Definitive Chemoradiotherapy, Prognostic Markers.

Proje Numarası

2018/21-11

Kaynakça

• 1. McGuire S. World Cancer Report 2014. Geneva, Switzerland: World Health Organization, International Agency for Research on Cancer, WHO Press, 2015. Adv Nutr An Int Rev J. 2016;7:418–9.
• 2. Bunn PA. Worldwide overview of the current status of lung cancer diagnosis and treatment. In: Archives of Pathology and Laboratory Medicine. 2012. p. 1478–81.
• 3. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68:394–424.
• 4. Ridge CA, McErlean AM, Ginsberg MS. Epidemiology of lung cancer. Semin Intervent Radiol. 2013;30:93–8.
• 5. Spiro SG, Porter JC. Lung cancer--where are we today? Current advances in staging and nonsurgical treatment. Am J Respir Crit Care Med. 2002;166:1166–96. 6. Alberg AJ. Cancer: Epidemiology of Lung Cancer. Encycl Hum Nutr. 2012;1–4:259–64.
• 7. Dela Cruz CS, Tanoue LT, Matthay RA. Lung cancer: epidemiology, etiology, and prevention. Clin Chest Med. 2011;32:605–44.
• 8. Inamura K. Lung Cancer: Understanding Its Molecular Pathology and the 2015 WHO Classification. Front Oncol. 2017;7:193.
• 9. Travis WD. Pathology of Lung Cancer. Clin Chest Med. 2011;32:669–92.
• 10. Masel EK, Berghoff AS, Füreder LM, Heicappell P, Schlieter F, Widhalm G, Gatterbauer B, Dieckmann U, Birner P, Bartsch R, Schur S, Watzke HH, Zielinski CC, Preusser M. Decreased body mass index is associated with impaired survival in lung cancer patients with brain metastases: A retrospective analysis of 624 patients. Eur J Cancer Care (Engl). 2017;26:e12707.
• 11. Zhu Q-Q, Wang C, Chen Y-Y, Ding Z-Y. Impaired Liver Function Implied Shorter Progression Free Survival for EGFR Tyrosine Kinase Inhibitors. Asian Pac J Cancer Prev. 2018;19:2177–81.
• 12. Arrieta O, Saavedra-Perez D, Kuri R, Aviles-Salas A, Martinez L, Mendoza-Posada D, Castillo P, Astorga A, Guzman E, De la Garza J. Brain metastasis development and poor survival associated with carcinoembryonic antigen (CEA) level in advanced non-small cell lung cancer: a prospective analysis. BMC Cancer. 2009;9:119.
• 13. Tomita M, Shimizu T, Hara M, Ayabe T, Onitsuka T. Preoperative leukocytosis, anemia and thrombocytosis are associated with poor survival in non-small cell lung cancer. Anticancer Res. 2009;29:2687–90.
• 14. Urvay SE, Yucel B, Erdis E, Turan N. Prognostic Factors in Stage III Non-Small-Cell Lung CancerPatients. Asian Pac J Cancer Prev. 2016;17:4693–7.
• 15. Kwas H, Guermazi E, Khattab A, Hrizi C, Zendah I, Ghédira H. Facteurs pronostiques du cancer bronchique non à petites cellules au stade avancé. Rev Pneumol Clin. 2017;73:180–7.
• 16. Unal D, Eroglu C, Kurtul N, Oguz A, Tasdemir A. Are neutrophil/lymphocyte and platelet/lymphocyte rates in patients with non-small cell lung cancer associated with treatment response and prognosis? Asian Pac J Cancer Prev. 2013;14:5237–42.
• 17. Kaçan T, Babacan NA, Yücel B, Kılıçkap S, Akkaş EA, Şeker MM, Eren MF, Eren AA. Evre IV küçük hücreli dışı akciğer kanserli hastaların sağkalımını etkileyen faktörler. Cumhur Med J. 2013;35:332–8.
• 18. Kefeli U, Öven BB, Yıldırım ME, Sonkaya A, Erkol B, Aydın D, Açıkgöz Ö. Akciğer kanserinde sağkalımı etkileyen klinikopatolojik özellikler Clinicopathological factors related to survival in lung cancer. Marmara Med J. 2015;28:21–6.
• 19. Cox JD, Azarnia N, Byhardt RW, Shin KH, Emami B, Pajak TF. A randomized phase I/II trial of hyperfractionated radiation therapy with total doses of 60.0 Gy to 79.2 Gy: possible survival benefit with greater than or equal to 69.6 Gy in favorable patients with Radiation Therapy Oncology Group stage III non-small- cell lung carcinoma: report of Radiation Therapy Oncology Group 83-11. J Clin Oncol. 1990;8:1543–55.
• 20. Kong F-M, Ten Haken RK, Schipper MJ, Sullivan MA, Chen M, Lopez C, Kalemkerian GP, Hayman JA. High-dose radiation improved local tumor control and overall survival in patients with inoperable/unresectable non–small-cell lung cancer: Long-term results of a radiation dose escalation study. Int J Radiat Oncol. 2005;63:324–33.
• 21. Yu D, Liu B, Zhang L, DU K. Platelet count predicts prognosis in operable non-small cell lung cancer. Exp Ther Med. 2013;5:1351–4.
• 22. Hao L, Zhang J, Di Y, Tan Z. Prognostic Value of White Blood Cells Detected for the First Time After Adjuvant Chemotherapy in Primary Operable Non-Small Cell Lung Cancer. Technol Cancer Res Treat. 2018;17:1533033818802813.
• 23. Scilla KA, Bentzen SM, Lam VK, Mohindra P, Nichols EM, Vyfhuis MA, Bhooshan N, Feigenberg SJ, Edelman MJ, Feliciano JL. Neutrophil‐Lymphocyte Ratio Is a Prognostic Marker in Patients with Locally Advanced (Stage IIIA and IIIB) Non‐Small Cell Lung Cancer Treated with Combined Modality Therapy. Oncologist. 2017;22:737–42.
• 24. Meriggi F, Codignola C, Beretta GD, Ceresoli GL, Caprioli A, Scartozzi M, Fraccon AP, Prochilo T, Ogliosi C, Zaniboni A. Significance of Neutrophil-to-lymphocyte Ratio in Western Advanced EGFR-mutated Non-small Cell Lung Cancer Receiving a Targeted Therapy. Tumori J. 2017;103:443–8.
• 25. Zhang Y, Feng Y-C, Zhu H-G, Xiong T-C, Hou Y-S, Song J, Jiang W, Zhu C-J. The peripheral blood neutrophil-to-lymphocyte ratio is a prognostic predictor for survival of EGFR-mutant nonsmall cell lung cancer patients treated with EGFR-TKIs. Medicine (Baltimore). 2018;97:e11648.
• 26. Lin GN, Peng JW, Liu PP, Liu DY, Xiao JJ, Chen XQ. Elevated neutrophil-to-lymphocyte ratio predicts poor outcome in patients with advanced non-small-cell lung cancer receiving first-line gefitinib or erlotinib treatment. Asia Pac J Clin Oncol. 2017;13:e189–94.
• 27. Cedrés S, Torrejon D, Martínez A, Martinez P, Navarro A, Zamora E, Mulet-Margalef N, Felip E. Neutrophil to lymphocyte ratio (NLR) as an indicator of poor prognosis in stage IV non-small cell lung cancer. Clin Transl Oncol. 2012;14:864–9.