TY - JOUR
T1 - A prognostic model for platinum-doublet as second-line chemotherapy in advanced non-small-cell lung cancer patients
AU - Mo, Hongnan
AU - Hao, Xuezhi
AU - Liu, Yutao
AU - Wang, Lin
AU - Hu, Xingsheng
AU - Xu, Jianping
AU - Yang, Sheng
AU - Xing, Puyuan
AU - Shi, Youwu
AU - Jia, Bo
AU - Wang, Yan
AU - Li, Junling
AU - Wang, Hongyu
AU - Wang, Ziping
AU - Sun, Yan
AU - Shi, Yuankai
N1 - Publisher Copyright:
© 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
PY - 2016/6/1
Y1 - 2016/6/1
N2 - Poor prognosis of advanced non-small-cell lung cancer (NSCLC) patients and the promising therapeutic effect of platinum urge the oncologists to evaluate the role of platinum doublet as second-line chemotherapy and establish the definition of platinum sensitivity in NSCLC. We retrospectively analyzed 364 advanced NSCLC patients who received platinum-doublet regimens as second-line chemotherapy after platinum-based first-line treatment. Patients were divided into four groups by their time-to-progression (TTP) after first-line chemotherapy: 0–3, 4–6, 7–12, and >12-month group, respectively. Treatment efficacy of patients' overall survival (OS), progression-free survival (PFS), and response rate (RR), as well as treatment-related toxicity, were compared among the four groups. A prognosis score system and a nomogram were established by Cox proportional hazard model, and validated by concordance index (c-index). Median OS was 14.0, 16.0, 20.0, 25.0 months for patients in the 0–3, 4–6, 7–12, >12-month group, respectively. Age ≤60 years (P = 0.002), female (P = 0.019), and TTP>12 months (P = 0.003) were independent prognostic factors. Prognostic score was calculated by adding 1 point each for any of the above three indicators, with a c-index of 0.590 (95% confidential interval [CI], 0.552–0.627). Median OS were equal to 25.0, 16.0, and 11.0 months for best (2–3 points), intermediate (1 point) and worst (0 point) category, respectively (P < 0.0001). A nomogram that integrated patient's age, gender, and TTP for OS has a c-index of 0.623 (95% CI, 0.603–0.643). Female, younger than 60 years, and TTP greater than 12 months may indicate prolonged survival after platinum-doublet second-line chemotherapy in advanced NSCLCpatients.
AB - Poor prognosis of advanced non-small-cell lung cancer (NSCLC) patients and the promising therapeutic effect of platinum urge the oncologists to evaluate the role of platinum doublet as second-line chemotherapy and establish the definition of platinum sensitivity in NSCLC. We retrospectively analyzed 364 advanced NSCLC patients who received platinum-doublet regimens as second-line chemotherapy after platinum-based first-line treatment. Patients were divided into four groups by their time-to-progression (TTP) after first-line chemotherapy: 0–3, 4–6, 7–12, and >12-month group, respectively. Treatment efficacy of patients' overall survival (OS), progression-free survival (PFS), and response rate (RR), as well as treatment-related toxicity, were compared among the four groups. A prognosis score system and a nomogram were established by Cox proportional hazard model, and validated by concordance index (c-index). Median OS was 14.0, 16.0, 20.0, 25.0 months for patients in the 0–3, 4–6, 7–12, >12-month group, respectively. Age ≤60 years (P = 0.002), female (P = 0.019), and TTP>12 months (P = 0.003) were independent prognostic factors. Prognostic score was calculated by adding 1 point each for any of the above three indicators, with a c-index of 0.590 (95% confidential interval [CI], 0.552–0.627). Median OS were equal to 25.0, 16.0, and 11.0 months for best (2–3 points), intermediate (1 point) and worst (0 point) category, respectively (P < 0.0001). A nomogram that integrated patient's age, gender, and TTP for OS has a c-index of 0.623 (95% CI, 0.603–0.643). Female, younger than 60 years, and TTP greater than 12 months may indicate prolonged survival after platinum-doublet second-line chemotherapy in advanced NSCLCpatients.
KW - Antineoplastic combined chemotherapy protocols
KW - Carcinoma
KW - Non-small-cell lung
KW - nomograms
KW - prognosis
KW - treatment outcome
UR - http://www.scopus.com/inward/record.url?scp=85006189410&partnerID=8YFLogxK
U2 - 10.1002/cam4.689
DO - 10.1002/cam4.689
M3 - Article
C2 - 26993156
AN - SCOPUS:85006189410
VL - 5
SP - 1116
EP - 1124
JO - Cancer Medicine
JF - Cancer Medicine
SN - 2045-7634
IS - 6
ER -