The Glasgow Prognostic Score as a Predictor of Survival after Chemoradiotherapy for Limited-Disease Small Cell Lung Cancer.

IF 2.5 3区医学 Q3 ONCOLOGY Oncology Pub Date : 2024-08-05 DOI:10.1159/000540651

Satoshi Endo, Hisao Imai, Ayako Shiono, Kosuke Hashimoto, Yu Miura, Shohei Okazaki, Takanori Abe, Atsuto Mouri, Kyoichi Kaira, Ken Masubuchi, Takeshi Masubuchi, Kunihiko Kobayashi, Koichi Minato, Shingo Kato, Hiroshi Kagamu

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Abstract

Introduction: Established biomarkers for predicting chemoradiotherapy efficacy for limited-disease small cell lung cancer (LD-SCLC) are lacking. The inflammation-based Glasgow Prognostic Score (GPS), comprising serum C-reactive protein (CRP) and albumin levels, can predict survival in advanced cancer. This study investigated whether metabolic and inflammatory markers, including the GPS, can predict the efficacy of chemoradiotherapy in patients with LD-SCLC.

Methods: We retrospectively analyzed 124 patients who underwent chemoradiotherapy for LD-SCLC at two institutions between April 2007 and June 2021, and assessed the prognostic significance of various metabolic and inflammatory markers. The GPS was calculated using the CRP and albumin concentrations, and categorized as follows: 0, CRP <1.0 mg/dL and albumin ≥3.5 mg/dL; 1, elevated CRP or decreased albumin; and 2, CRP ≥1.0 mg/dL and albumin<3.5 mg/dL. Differences in progression-free survival (PFS) and overall survival (OS) were examined using Kaplan-Meier curves and Cox proportional-hazard models.

Results: The overall response rate was 95.1% (95% confidence interval [CI]: 89.6-97.9%). The median PFS and OS from chemoradiotherapy initiation were 12.6 (95% CI: 9.9-15.4) and 29.0 (95% CI: 24.8-45.5) months, respectively. The GPS demonstrated independent predictive ability for the effectiveness of chemoradiotherapy, wherein favorable scores (GPS 0-1) were significantly correlated with superior PFS and OS compared to unfavorable scores (GPS 2: PFS: 14.8 vs. 6.7 months, p = 0.0001; OS: 35.4 vs. 11.0 months, p < 0.0001).

Conclusion: This preliminary examination revealed that the GPS was significantly associated with PFS and OS in patients undergoing chemoradiotherapy for LD-SCLC, indicating its potential utility in assessing the therapeutic outcomes in LD-SCLC.

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格拉斯哥预后评分预测局限性小细胞肺癌化疗后的生存率

导言：目前尚缺乏预测局限性小细胞肺癌（LD-SCLC）化放疗疗效的成熟生物标志物。基于炎症的格拉斯哥预后评分（GPS）由血清C反应蛋白（CRP）和白蛋白水平组成，可预测晚期癌症患者的生存期。本研究探讨了包括GPS在内的代谢和炎症指标能否预测LD-SCLC患者化放疗的疗效：我们回顾性分析了2007年4月至2021年6月期间在两家机构接受化放疗的124例LD-SCLC患者，并评估了各种代谢和炎症指标的预后意义。GPS使用CRP和白蛋白浓度进行计算，并分为以下几类：0，CRP<1.0 mg/dL，白蛋白≥3.5 mg/dL；1，CRP升高或白蛋白降低；2，CRP≥1.0 mg/dL，白蛋白<3.5 mg/dL。采用卡普兰-梅耶曲线和考克斯比例危险模型检验了无进展生存期（PFS）和总生存期（OS）的差异：总反应率为 95.1%（95% 置信区间 [CI]：89.6%-97.9%）。自开始化疗起的中位生存期和OS分别为12.6个月（95% CI：9.9-15.4）和29.0个月（95% CI：24.8-45.5）。GPS对化疗放疗的有效性具有独立的预测能力，与不利评分相比，有利评分（GPS 0-1）与较好的PFS和OS显著相关（GPS 2：PFS：14.8个月 vs. 6.7个月，p=0.0001；OS：35.4个月 vs. 11.0个月，p=0.0001）：结论：这项初步研究表明，GPS与接受LD-SCLC化疗的患者的PFS和OS显著相关，表明其在评估LD-SCLC治疗效果方面具有潜在的实用性。

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来源期刊

Oncology 医学-肿瘤学

CiteScore

6.00

自引率

2.90%

发文量

审稿时长

6-12 weeks

期刊介绍： Although laboratory and clinical cancer research need to be closely linked, observations at the basic level often remain removed from medical applications. This journal works to accelerate the translation of experimental results into the clinic, and back again into the laboratory for further investigation. The fundamental purpose of this effort is to advance clinically-relevant knowledge of cancer, and improve the outcome of prevention, diagnosis and treatment of malignant disease. The journal publishes significant clinical studies from cancer programs around the world, along with important translational laboratory findings, mini-reviews (invited and submitted) and in-depth discussions of evolving and controversial topics in the oncology arena. A unique feature of the journal is a new section which focuses on rapid peer-review and subsequent publication of short reports of phase 1 and phase 2 clinical cancer trials, with a goal of insuring that high-quality clinical cancer research quickly enters the public domain, regardless of the trial’s ultimate conclusions regarding efficacy or toxicity.