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

Year 2021, Volume: 22 Issue: 6, 468 - 472, 18.10.2021

Emine Elif Özkan , Zümrüt Arda Kaymak

https://doi.org/10.18229/kocatepetip.798147

Abstract

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.

Keywords

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

Abstract

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.

Keywords

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

References

• 1. Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. CA Cancer J Clin. 2014; 64:9-29.
• 2. Devesa SS, Bray F, Vizcaino AP, Parkin D.M. International lung cancer trends by histologic type: male:female differences diminishing and adenocarcinoma rates rising. Int J Cancer. 2005; 117:294-9.
• 3. Aynaci Ö, Canyilmaz E, Serdar L, Kandaz M, Bahat ZM, Yoney A. Survival and prognostic factors in limited stage small cell lung cancer: A retrospective study from northeast Turkey. J Cancer Res Ther. 2016;12(1):238-43.
• 4. Winther-Larsen A, Hoffmann L, Moeller DS, Khalil AA, Knap MM. Evaluation of factors associated with loco-regional failure and survival in limited disease small cell lung cancer patients treated with chemoradiotherapy. Acta Oncol. 2015;54(9):1574-81.
• 5. Videtic GM, Stitt LW, Dar AR, et al. Continued cigarette smoking by patients receiving concurrent chemoradiotherapy for limited-stage small-cell lung cancer is associated with decreased survival. J Clin Oncol. 2003;21(8):1544-49.
• 6. Fukui T, Itabashi M, Ishihara M. et al. Prognostic factors affecting the risk of thoracic progression in extensive-stage small cell lung cancer. BMC Cancer. 2016;8(16):197.
• 7. Hussain SP, Harris CC. Inflammation and cancer: an ancient link with novel potentials. Int J Cancer. 2007;121(11):2373-80.
• 8. Batista MJ, Peres SB, McDonald ME, et al. Adipose tissue inflammation and cancer cachexia: possible role of nuclear transcription factors. Cytokine. 2012;57(1):9-16.
• 9. Lee SC, Huh JW, Lee WY, et al. Prognostic value of serum inflammatory markers in colorectal cancer. Int J Colorectal Dis. 2020;35(7):1211-19.
• 10. Yamamoto M, Kurokawa Y, Kobayashi N, et al. Prognostic Value of the Combined Index of Plasma Fibrinogen and the Neutrophil-Lymphocyte Ratio in Gastric Cancer. World J Surg. 2020;44(1):207-12.
• 11. Zhang N, Jiang J, Tang S, Sun G. Predictive value of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in non-small cell lung cancer patients treated with immune checkpoint inhibitors: A meta-analysis. Int Immunopharmacol. 2020;85:106677.
• 12. Lohinai Z, Bonanno L, Aksarin A, et al. Neutrophil-lymphocyte ratio is prognostic in early stage resected small-cell lung cancer. PeerJ. 2019;29;7:7232.
• 13. Aleksandrova K, Boeing H, Nothlings U, et al. Inflammatory and metabolic biomarkers and risk of liver and biliary tract cancer. Hepatology. 2014;60(3):858-71.
• 14. Chen C, Sun P, Dai QS, Weng HW, Li HP, Ye S. The Glasgow Prognostic Score predicts poor survival in cisplatin-based treated patients with metastatic nasopharyngeal carcinoma. PLoS One. 2014;9(11):112581.
• 15. Jafri SH, Shi R, Mills G. Advance lung cancer inflammation index (ALI) at diagnosis is a prognostic marker in patients with metastatic non-small-cell lung cancer (NSCLC): a retrospective review. BMC Cancer 2013;13:158.
• 16. Feng JF, Huang Y, Chen QX. A new inflammation index is useful for patients with esophageal squamous cell carcinoma. Onco Targets Ther 2014;7:1811-5.
• 17. He X, Zhou T, Yang Y, Hong S, Zhan J, Hu Z. Advanced Lung Cancer Inflammation Index, a New Prognostic Score, Predicts Outcome in Patients with Small-Cell Lung Cancer. Clin Lung Cancer. 2015;16(6):165-71.
• 18. Demaria S, Pikarsky E, Karin M, et al. Cancer and inflammation: promise for biologic therapy. J Immunother 2010; 33:335-51.
• 19. Coussens LM, Werb Z. Inflammation and cancer. Nature. 2002;420(6917):860-7.
• 20. Bernhardt D, Aufderstrasse S, König L, et al. Impact of inflammatory markers on survival in patients with limited disease small-cell lung cancer undergoing chemoradiotherapy. Cancer Manag Res. 2018;10:6563-69.
• 21. Kang MH, Go SI, Song HN, et al. The prognostic impact of the neutrophilto-lymphocyte ratio in patients with small-cell lung cancer. Br J Cancer 2014;111(3):452-60.
• 22. Voronova V, Glybochko P, Svistunov A, et al. Diagnostic Value of Combinatorial Markers in Colorectal Carcinoma. Front Oncol. 2020;10:832.
• 23. Syniachenko O, Yehudina Y, Stoliarova O, Suprun O, Makhnova A. Markers of The Lung Cancer Complications. Georgian Med News. 2019;(286):19-23.
• 24. McMillan DC. Systemic inflammation, nutritional status and survival in patients with cancer. Curr Opin Clin Nutr Metab Care 2009; 12(3):223-6.
• 25. Eckart A, Struja T, Kutz A, et al. Relationship of Nutritional Status, Inflammation, and Serum Albumin Levels During Acute Illness: A Prospective Study. Am J Med. 2020;133(6):713-722.7.
• 26. Costa RGF, Caro PL, de Matos-Neto EM, et al. Cancer cachexia induces morphological and inflammatory changes in the intestinal mucosa. J Cachexia Sarcopenia Muscle. 2019;10(5):1116-27.
• 27. Fiala O, Pesek M, Finek J, et al. Serum albumin is a strong predictor of survival in patients with advanced-stage non-small cell lung cancer treated with erlotinib. Neoplasma. 2016;63(3):471-76.
• 28. Wang J, Yang DL, Chen ZZ, Gou BF. Associations of body mass index with cancer incidence among populations, genders, and menopausal status: A systematic review and meta-analysis. Cancer Epidemiol. 2016;42:1-8.
• 29. Zhang Y, Chen B. Prognostic Value of the Advanced Lung Cancer Inflammation Index in Patients with Lung Cancer: A Meta-Analysis. Dis Markers. 2019;2019:2513026.