KMID : 0338420200350061468
|
|
Korean Journal of Internal Medicine 2020 Volume.35 No. 6 p.1468 ~ p.1476
|
|
Impact of subsequent chemotherapy on the survival of elderly patients with extensive stage small cell lung cancer
|
|
Kang Eun-Joo
Choi Yoon-Ji Lee Se-Ryeon Sung Hwa-Jung Kim Jung-Sun
|
|
Abstract
|
|
|
Background/Aims: The prognosis of small cell lung cancer (SCLC) is still poor because of rapid recurrence, despite good response to initial chemotherapy. Additionally, patients¡¯ old ages and comorbidities are often obstacles that make it difficult to apply subsequent treatment after initial treatment. This retrospective study analyzed the correlation of post-progression survival (PPS) with overall survival (OS), and prognostic factors including comorbidities to figure out impact of subsequent chemotherapy on OS in elderly extensive disease SCLC.
Methods: We analyzed 101 patients of age 65 years or older who were recently diagnosed with extensive disease SCLC (ED-SCLC) in Korea University Medical Center between January 1995 and December 2015. The degree of comorbidity was scored using simplified comorbidity score (SCS). Correlation between PPS, progression-free survival (PFS) and OS was analyzed using a Pearson correlation coefficient. Cox proportional hazards regression was employed to examine the influence of clinical variables on survival.
Results: Median age of patients was 71 years old (range, 65 to 83). Median OS was 8.7 months (range, 0.3 to 42.7). PPS was a reliable factor on OS than PFS (R2 = 0.852, p < 0.001). Prognostic factors associated with improved survival were SCS < 9, administration > 4 cycles of first line chemotherapy and subsequent second line chemotherapy.
Conclusions: PPS was more correlated with OS than PFS in elderly patients with ED-SCLC. The most important prognostic factors for PPS and OS included SCS and second line chemotherapy. Patients receiving subsequent treatment had increased OS regardless of degree of comorbidity.
|
|
KEYWORD
|
|
Small cell lung cancer, Comorbidity, Prognosis, Chemotherapy, Post-progression survival
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|