哥伦比亚麦德林癌症中心晚期非小细胞肺癌的生存结局

M. Lema, B. Preciado, Camila Lema, D. Rodríguez, Mateo Pineda, Jorge Egurrola, J. P. Ospina, Esteban Calle, M. Luján, A. Yépes, D. Morán
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Median age was 70.1 years (IQR:64.6-77.2). Adenocarcinoma in 57.7%. First-line treatment was chemotherapy (48.1%), immunotherapy (40.4%), and anti-ALK/EGFR tyrosine-kinase inhibitors (TKI) (9.6%). One patient was enrolled in a clinical trial. Median PFS and OS for the entire cohort were 6.0 months (95%CI:4.8-7.1) and 11 months (95%CI:6.7-15.3), respectively. Median OS for performance-status (PS) 1-2 was 14.5 months (95%CI:7.3-21.7) and 4.7 months (95%CI:2.7-6.7) for PS 2-4 (P=0.002). Median PFS for chemotherapy, immunotherapy, and TKI were 3.3 months (95%CI:0.8-5.8), 9.9 months (95%CI:4.6-15.2), and not reached, respectively (P<0.001). Median OS for chemotherapy, immunotherapy, and TKI were 6.0 months (95%CI:1.9-10.0), 9.9 months (95%CI:8.1-11.8), and not reached, respectively (P=0.080). 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摘要

文献中报道的非小细胞肺癌(NSCLC)的生存结果可能不适用于哥伦比亚现实生活中的患者。这项研究的目的是在哥伦比亚Medellín de Oncología Astorga治疗的NSCLC患者队列中描述这些情况。方法:采用生存分析的观察性研究。纳入了2019年1月1日起在该机构接受治疗的晚期NSCLC患者。回顾性分析病历。Kaplan Meier法评估无进展生存期(PFS)和总生存期(OS)。为了比较生存分布,采用log-rank检验。结果:纳入52例患者。中位年龄70.1岁(IQR:64.6-77.2)。腺癌占57.7%。一线治疗是化疗(48.1%)、免疫治疗(40.4%)和抗alk /EGFR酪氨酸激酶抑制剂(TKI)(9.6%)。一名患者参加了临床试验。整个队列的中位PFS和OS分别为6.0个月(95%CI:4.8-7.1)和11个月(95%CI:6.7-15.3)。性能状态(PS) 1-2的中位生存期为14.5个月(95%CI:7.3-21.7), PS 2-4的中位生存期为4.7个月(95%CI:2.7-6.7) (P=0.002)。化疗、免疫治疗和TKI的中位PFS分别为3.3个月(95%CI:0.8-5.8)、9.9个月(95%CI:4.6-15.2)和未达到(P<0.001)。化疗、免疫治疗和TKI的中位OS分别为6.0个月(95%CI:1.9-10.0)、9.9个月(95%CI:8.1-11.8)和未达到(P=0.080)。结论:在哥伦比亚这个中低收入国家,晚期非小细胞肺癌的临床结果可以更好地告知患者和提供者特定环境的生存期望。PS差的晚期疾病和缺乏获得最先进治疗的机会是尚待解决的挑战。
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Survival Outcomes in Advanced Non-Small Cell Lung Cancer in a Cancer Center in Medellin - Colombia
Introduction: survival outcomes of Non-Small Cell Lung Cancer (NSCLC) reported in the literature may not apply to patients in a real-life scenario in Colombia. This study aims to describe these in a cohort of patients with NSCLC treated at Clínica de Oncología Astorga, in Medellín, Colombia. Methods: this is an observational study with survival analysis. Patients with advanced NSCLC established from January 1/2019 treated at the Institution were included. Medical records were analyzed retrospectively. Kaplan Meier method was used to estimate progression-free survival (PFS) and overall survival (OS). To compare the survival distributions log-rank test was performed. Results: fifty-two patients were included. Median age was 70.1 years (IQR:64.6-77.2). Adenocarcinoma in 57.7%. First-line treatment was chemotherapy (48.1%), immunotherapy (40.4%), and anti-ALK/EGFR tyrosine-kinase inhibitors (TKI) (9.6%). One patient was enrolled in a clinical trial. Median PFS and OS for the entire cohort were 6.0 months (95%CI:4.8-7.1) and 11 months (95%CI:6.7-15.3), respectively. Median OS for performance-status (PS) 1-2 was 14.5 months (95%CI:7.3-21.7) and 4.7 months (95%CI:2.7-6.7) for PS 2-4 (P=0.002). Median PFS for chemotherapy, immunotherapy, and TKI were 3.3 months (95%CI:0.8-5.8), 9.9 months (95%CI:4.6-15.2), and not reached, respectively (P<0.001). Median OS for chemotherapy, immunotherapy, and TKI were 6.0 months (95%CI:1.9-10.0), 9.9 months (95%CI:8.1-11.8), and not reached, respectively (P=0.080). Conclusion: clinical outcomes in Real-World-Setting in advanced NSCLC in Colombia, a Low-Middle-Income-Country, can better inform patients and providers in regards to setting-specific survival expectations. Advanced disease with poor PS and lack of access to state-of-art therapy are challenges yet to be addressed.
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