SINIRLI EVRE KÜÇÜK HÜCRELİ AKCİĞER KANSERİ OLGULARINDA TEDAVİ ÖNCESİ İLERİ AKCİĞER KANSERİ ENFLAMSAYON İNDEKS DEĞERLERİNİN PROGNOSTİK ÖNEMİNİN ARAŞTIRILMASI

Öz

AMAÇ: İleri akciğer kanseri enflamasyon indeksi (İAKEİ), başta Küçük Hücreli Dışı Akciğer Kanseri (KHDAK)olmak üzere birçok kanserde yakın zamanda değerlendirilen enflamatuar indekslerden biridir. Ancak Küçük Hücreli Akciğer kanseri (KHAK) vakalarında aynı konudaki veriler azdır. Bu çalışmada, küratif amaçla tedavi edilen sınırlı evre KHAK hastalarında tedavi öncesi İAKEİ ile sağkalım arasındaki ilişkinin araştırılması amaçlandı.
GEREÇ VE YÖNTEM: Küratif amaçla torasik radyoterapi (RT) uygulanan 21 sınırlı evre KHAK hastası retrospektif olarak değerlendirildi. RT, 3D konformal (3DCRT) veya yoğunluk ayarlı RT (YART) teknikleri kullanılarak medyan 60 Gy olarak verildi. İAKEİ değerinin hesaplanmasında kullanılan değişkenler hastaların elektronik dosyalarından elde edildi. Hastalar düşük ve yüksek İAKEİ değeri olmak üzere iki grupta incelendi. Her iki grup için genel (GS) ve progresyonsuz sağkalım (PS) sonuçlarını elde etmek için Kaplan Meier sağkalım analizi kullanıldı. Cox regresyon testi ile tek değişkenli ve çok değişkenli analiz yapıldı.
BULGULAR: Medyan 26 (5,16-70,6) ay takip süresi sonunda 5 hasta halen hayattadır. Lokal ve uzak nüks oranları sırasıyla %47,6 ve %57,1 olarak bulunmuştur. Tüm kohortun PS ve GS’ı sırasıyla medyan 13,7 (5,16-82,76) ve 25,07 (6,9-85,59) aydı. İAKEİ<38 olan grupta medyan GS ve PS 22,4 ve 13,56 ay iken, İAKEİ>38 olan grupta sırasıyla 25,06 ve 13,7 idi (p=0,709 ve p=0,744). Tek ve çok değişkenli analizde incelenen diğer değişkenlerin hiçbiri istatistiksel olarak anlamlı bulunmadı (tek değişkenli analiz için p=0,059-0.930 ve çok değişkenli analiz için p=0.07-0.89).
SONUÇ: Çalışmamızda sınırlı evre KHAK olgularında tedavi öncesi İAKEİ değerinin sağkalıma prognostik etkisinin olmadığını saptadık. Sonuçlarımız ile önceki raporlar arasındaki uyumsuzluk, önceki çalışmalara kıyasla serimizdeki yüksek İAKEİ değerlerine ve sadece sınırlı evre KHAK hastalarının kaydına bağlanabilir.

Anahtar Kelimeler

• Sınırlı evre küçük hücreli akciğer kanseri
• İleri akciğer kanseri enflamasyon indeksi
• Sağkalım

INVESTIGATION OF THE PROGNOSTIC IMPORTANCE OF PRE-TREATMENT ADVANCED LUNG CANCER INFLAMMATION INDEX VALUES IN LIMITED STAGE SMALL- CELL LUNG CANCERS

Öz

OBJECTIVE: Advanced lung cancer inflammation index (ALI) is one of the recently evaluated inflammatory indexes in many cancers, foremost Non-Small Cell Lung Cancer (NSCLC). However data in the same issue in Small Cell Lung Cancer (SCLC) cases is scarce. In this study the its aimed to investigate the correlation between pretreatment ALI and survival in limited stage SCLC patients treated with curative intend.
MATERIAL AND METHODS: Twenty-one limited stage SCLC patients who underwent definitive thoracic radiotherapy (RT) were retrospectively evaluated. RT was given as median 60 Gy using 3D conformal (3DCRT) or intensity modulated RT (IMRT) techniques. Variables used to calculate ALI value were attained from the electronical charts of the patients. Patients were evaluated in two groups as low and high ALI value. Kaplan Meier survival analysis was used to achieve overall (OS) and progression free survival (PFS) results for both groups. Univariate and multivariate analysis were done by Cox regression test.
RESULTS: Five patients are alive after median 26 (5,16-70,6) months of follow up. Local and distant recurrence rates were found to be 47,6% and 57,1% respectively. PFS and OS of whole cohort were median 13,7 (5,16-82,76) and 25,07 (6,9-85,59) months respectively. Median OS and PFS of group with ALI<38 were 22,4 and 13,56 months where in the group with ALI >38, they were 25,06 and 13,7 respectively (p=0,709 ve p=0,744). None of the other variables investigated in uni and multivariant analysis were found to be statistically significant (p=0,059-0,930 for univariant analysis and p=0.07– 0.89 for mutivariant analysis).
CONCLUSIONS: In our study we detected that pretreatment ALI value have no prognostic effect on survival in limited stage SCLC cases. The discordance between our results and the previous reports can be attributed to high ALI values in our series compared to previous studies and enrolment of only limited stage SCLC patients.

Anahtar Kelimeler

• Limitedstage small cell lung cancer
• Advanced lung cancer inflammatiom index
• Survival

Kaynakça

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