Impact of obstructive sleep apnea risk on prognosis and treatment responses of lung cancer

Abstract

Aims: Obstructive sleep apnea (OSA) may affect oncogenic processes in a specific way for each tumor type. This study was conducted to reveal the relationship between OSA risk and prognosis and treatment responses in patients with lung cancer. Methods: This prospective study included stage III and IV lung cancer patients aged between 18 and 75 years. Patients with poor performance status, cranial metastasis, congestive heart failure, surgery history, and positive airway pressure device use were excluded. STOP-BANG questionnaire was used to assess the OSA risk. The primary end-point was the differences in the survival and treatment responses of patients at intermediate/high risk of OSA compared with those at low OSA risk. Data from the patients with non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) were analyzed separately. Results: Ninety-eight patients (34 SCLC and 64 NSCLC), mostly male (85.7%), with a mean age of 59.3±8 were included in the analysis. Overall survival was similar in the groups. However, in the SCLC group, those at low OSA risk had a shorter progression-free survival (PFS) than those at intermediate/high risk (105±31.8 days, vs 272±16.2 days, p=0.001). Cox regression analysis showed that low OSA risk was an independent risk factor for PFS in only the SCLC group (HR:4.9 CI:1.6-14.7, p=0.005). Conclusion: IOur results showed that low OSA risk was an independent poor prognostic factor for PFS in SCLC regardless of the tumor stage.

Keywords

• Lung cancer
• obstructive sleep apnea
• overall survival
• progression-free survival
• STOP-BANG questionnaire

Obstrüktif uyku apnesi riskinin akciğer kanserinin prognozu ve tedavi yanıtlarına etkisi

Abstract

Amaç: Obstrüktif uyku apnesi (OSA), her tümör tipi için onkojenik süreçleri spesifik bir şekilde etkileyebilir. Bu çalışma akciğer kanserli hastalarda OSA riski ile prognoz ve tedavi yanıtları arasındaki ilişkiyi ortaya koymak amacıyla yapılmıştır. Yöntemler: Bu prospektif çalışmaya 18-75 yaşları arasındaki evre III ve IV akciğer kanseri hastaları dahil edildi. Performans durumu kötü olan, kranial metastazı olan, konjestif kalp yetmezliği olan, ameliyat öyküsü olan ve pozitif hava yolu basıncı cihazı kullanan hastalar çalışma dışı bırakıldı. OSA riskini değerlendirmek için STOP-BANG anketi kullanıldı. Birincil sonlanım noktası olarak, düşük OSA riski olan hastalar orta/yüksek OSA riski taşıyanlarla sağkalım ve tedavi yanıtlarındaki farklılıklar açısından karşılaştırıldı. Küçük hücreli dışı akciğer kanseri (KHDAK) ve küçük hücreli akciğer kanseri (KHAK) hastalarına ait veriler ayrı ayrı analiz edildi. Bulgular: Analize yaş ortalaması 59,3±8 olan, çoğu erkek (%85,7) olmak üzere 98 hasta (34 KHAK ve 64 KHDAK) dahil edildi. Genel sağkalım gruplarda benzerdi. Bununla birlikte, KHAK grubunda düşük OSA riski taşıyanların progresyonsuz sağkalım (PFS) süresi orta/yüksek riskli olanlara göre daha kısaydı (105±31,8 gün, vs 272±16,2 gün, p=0,001). Cox regresyon analizi, düşük OSA riskinin yalnızca KHAK grubunda PFS için bağımsız bir risk faktörü olduğunu gösterdi (HR:4,9 CI:1,6-14,7, p=0,005). Sonuç: Sonuçlarımız, düşük OSA riskinin, tümör evresinden bağımsız olarak KHAK'de PFS için kötü prognostik faktör olduğunu göstermektedir.

Keywords

• Akciğer kanseri
• obstrüktif uyku apnesi
• genel sağkalım
• progresyonsuz sağkalım
• STOP-BANG anketi

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