Prognostic factors affecting survival in third-line treatment of advanced non-small cell lung cancer: Retrospective cohort study

Öz

Aim: In patients who have reached third-line treatment, survival times are short and response to treatment is poor. However, in some patients, survival times and treatment responses are good despite advanced treatment lines. The present study investigates the prognostic factors that affect survival among patients who have undergone third-line treatment for non-small cell lung cancer (NSCLC).
Methods: Among the 1,150 patients who were treated for and followed-up with a diagnosis of NSCLC between January 2008 and December 2015, 102 (8%) who had received third-line treatment were included in this retrospective cohort study.
Results: The mean patient age was 56 years (SD: 10.1), and 70.6% were male. The third-line treatment provided a median PFS of 2.36 (range: 1.15–36.1) months and an OS of 4.2 (range: 1.28–38.1) months. Cox hazard-model analyses indicated significant associations between prolonged survival and gender, smoking, non-squamous histology, age below 45 years, the presence of EGFR mutations and the use of EGFR tyrosine kinase inhibitors.
Conclusion: The prognosis may be better for some patients who have reached third-line treatments, namely, young patients, females, non-smokers, and those with a non-squamous histology. In these patients, physicians should be alert in terms of driver mutations, such as EGFR mutation.

Anahtar Kelimeler

• Third-line treatment,Anti-EGFR,Treatment,Prognosis,Non-small cell lung cancer

İleri evre küçük hücre dışı akciğer kanserinde üçüncü basamak tedavide sağ kalımı ekileyen prognostik faktörler: Retrospektif kohort çalışma

Öz

Amaç: Üçüncü basamak tedaviye ulaşmış hastalarda sağkalım süreleri kısa ve tedaviye yanıtları kötüdür. Ancak bazı hastalarda sağkalım süreleri ve tedavi yanıtları ilerlemiş tedavi basamağına rağmen iyidir. Bu çalışmadaki amacımız, küçük hücreli dışı akciğer kanserinde (KHDAK) üçüncü basamak tedaviye ulaşmış olan hastaların sağkalımlarını etkileyen prognostik faktörleri saptamaktır.
Yöntemler: Ocak 2008-Aralık 2015 tarihleri arasında KHDAK tanısı ile tedavi edilen ve takip edilen 1.150 hastadan üçüncü basamak tedavi alan 102 (%8) hasta bu retrospektif kohort çalışmada değerlendirildi.
Bulgular: Hastaların ortalama yaşı 54 (Standard sapma: 10,1) ve %70,6 sı erkekti. Üçüncü basmakta ortanca progresyonsuz sağkalım süresi ortanca 2.36 (Aralık: 1,15-36,1) ve ortanca toplam sağkalım 4.2 (1,28-38,1) aydı. Cox hazard modeli analizinde uzun sağkalımı etkileyen temel faktörler; cinsiyet, sigara, skuamöz dışı histoloji, 45 yaş altında olmak, EGFR mutasyon durumu ve Anti-EGFR tedavi almış olmak olarak saptandı.
Sonuç: Kadın, sigara içmeyen, skuamöz dışı histolojisi olan, genç olan üçüncü basamak tedaviye ulaşmış hastalarda prognozun daha iyi olabileceği ve bu hastalarda EGFR mutasyonu gibi driver mutasyonları açısından hassas olunması gerektiği bilinmelidir.

Anahtar Kelimeler

• Üçüncü basamak tedavi,Anti-EGFR,Tedavi,Prognoz,Küçük hücre dışı akciğer kanseri

Kaynakça

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