小细胞肺癌(SCLC)分级预后评估的有效性检验以及针对 SCLC 脑转移患者的新指标建议

IF 2.7 3区 医学 Q3 ONCOLOGY
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引用次数: 0

摘要

背景和目的我们对最近报道的小细胞肺癌(SCLC)分级预后评估(GPA)系统进行了有效性测试,该系统适用于有脑转移(BMs)的SCLC患者。材料与方法 我们从 1998 年以来连续接受伽马刀 SRS 治疗的近 7000 名 SCLC 患者中挑选了 508 名患者进行研究。结果 在 SCLC GPA 中,相邻亚组之间的中位生存时间(MST)没有差异。因此,508 例患者被随机分为两个系列,即试验系列(340 例)和验证系列(168 例)。在测试系列中,通过单变量分析确定了五个有利于延长生存期的因素(HR 的整数下限 95 % CI 至少为 1.3):性别、卡诺夫斯基表现状态、肿瘤数目、原发肿瘤状态和脑外转移。这一新指数是这五个因素得分(0 和 1)的总和:SCLC-4-6级(4、5或6分)、2-3级(2或3分)和0-1级(0或1分)。这一新系统显示,各亚类之间的 MST 差异具有高度统计学意义。接下来,该 SCLC 等级被应用于验证序列。结论我们对 SCLC GPA 的有效性测试结果表明,该系统不能准确反映 SCLC BM 患者的预后。我们的结果表明,本文提出的 SCLC 分级具有更高的预后价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Validity test of small cell lung cancer (SCLC) graded prognostic assessment and proposal of a new index for patients with brain metastases from SCLC

Background and purpose

We performed a validity test of a recently-reported, small cell lung cancer (SCLC) graded prognostic assessment (GPA) system for SCLC patients with brain metastases (BMs). Thereafter, we created a new prognostic index, the SCLC Grade, for such patients.

Materials and methods

We studied 508 SCLC patients selected from among nearly 7000 consecutive patients undergoing gamma knife SRS for BMs since 1998.

Results

In the SCLC GPA, there were no median survival time (MST) differences among pairs of the neighboring subgroups. Therefore, the 508 patients were randomly divided into the two series, i.e., a test (340 patients) and a validity (168) series. In the test series, five factors were identified by univariable analyses as favoring longer survival (rounded lower 95 % CI of the HR was at least 1.3): Sex, Karnofsky Performance Status, tumor numbers, primary tumor status and extracerebral metastases. This new index is the sum of scores (0 and 1) of these five factors: SCLC-Grade 4–6 (score of 4, 5 or 6), 2–3 (2 or 3), and 0–1 (0 or 1). This new system showed highly statistically significant MST differences among subclasses. Next, this SCLC-Grade was applied to the verification series. Consistent results were obtained, i.e., there were highly statistically significant MST differences among subclasses.

Conclusions

Our validity test results for the SCLC GPA demonstrated this system to not precisely reflect the outcomes of SCLC patients with BMs. Our results suggest the herein-proposed SCLC-Grade to have superior prognostic value.

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来源期刊
Clinical and Translational Radiation Oncology
Clinical and Translational Radiation Oncology Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
5.30
自引率
3.20%
发文量
114
审稿时长
40 days
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