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Impact of inflammatory markers on survival in patients with limited disease small-cell lung cancer undergoing chemoradiotherapy

BACKGROUND: Systemic inflammation appears to play a role in the progression of numerous solid tumors by promoting tumor proliferation. Our current study aimed to evaluate the role of inflammatory markers in limited disease (LD) small-cell lung cancer (SCLC) patients undergoing thoracic chemoradiothe...

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Autores principales: Bernhardt, Denise, Aufderstrasse, Sophie, König, Laila, Adeberg, Sebastian, Bozorgmehr, Farastuk, Christopoulos, Petros, Shafie, Rami A El, Hörner-Rieber, Juliane, Kappes, Jutta, Thomas, Michael, Herth, Felix, Steins, Martin, Debus, Jürgen, Rieken, Stefan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6280890/
https://www.ncbi.nlm.nih.gov/pubmed/30555261
http://dx.doi.org/10.2147/CMAR.S180990
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author Bernhardt, Denise
Aufderstrasse, Sophie
König, Laila
Adeberg, Sebastian
Bozorgmehr, Farastuk
Christopoulos, Petros
Shafie, Rami A El
Hörner-Rieber, Juliane
Kappes, Jutta
Thomas, Michael
Herth, Felix
Steins, Martin
Debus, Jürgen
Rieken, Stefan
author_facet Bernhardt, Denise
Aufderstrasse, Sophie
König, Laila
Adeberg, Sebastian
Bozorgmehr, Farastuk
Christopoulos, Petros
Shafie, Rami A El
Hörner-Rieber, Juliane
Kappes, Jutta
Thomas, Michael
Herth, Felix
Steins, Martin
Debus, Jürgen
Rieken, Stefan
author_sort Bernhardt, Denise
collection PubMed
description BACKGROUND: Systemic inflammation appears to play a role in the progression of numerous solid tumors by promoting tumor proliferation. Our current study aimed to evaluate the role of inflammatory markers in limited disease (LD) small-cell lung cancer (SCLC) patients undergoing thoracic chemoradiotherapy (TCR). PATIENTS AND METHODS: We retrospectively analyzed a total number of 350 SCLC patients diagnosed with LD SCLC who received TCR between 1999 and 2017 and had available blood tests within 2 weeks prior to the start of TCR. Serum C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase (LDH), hemoglobin (Hb) levels, and platelet count (Pc) were evaluated as potential inflammatory markers. Kaplan–Meier survival analysis was performed for overall survival (OS). For comparison of survival curves, the log-rank (Mantel–Cox) test was used. Univariate and multivariate Cox proportional HRs were used to assess the influence of cofactors on OS. RESULTS: Univariate analysis for OS revealed a statistically significant effect for LDH >400 U/L (HR 2.05 U/L; 95% CI 1.29–3.26 U/L; P=0.002), prophylactic cranial irradiation (PCI; HR 0.58; 95% CI 0.40–0.85; P=0.005), CRP >50 mg/L (HR 1.49 mg/L; 95% CI 1.05–2.10 mg/L; P=0.026), and Karnofsky performance scale (KPS) <70% (HR 1.35%; 95% CI 1.02–1.80%; P=0.035). NLR, age (>70 years), Hb levels, and Pc did not influence survival. In multivariate analysis, OS was significantly affected by PCI (HR 0.64; 95% CI 0.43–0.94; P=0.026), LDH >400 U/L (HR 1.91 U/L; 95% CI 1.21–3.05 U/L; P=0.006), and CRP >50 mg/L (HR 1.43 mg/L; 95% CI 1.01–2.04 mg/L; P=0.045). KPS (≤70%) did not influence survival in multivariate analysis. CONCLUSION: Elevated CRP and LDH seem to be the independent prognostic factors for OS in LD SCLC patients undergoing TCR. However, elevated NLR was not found to be an independent prognostic factor for OS if taken prior to TCR. LDH and CRP are easily available blood tests and do not require additional resources for routine use and could be useful for clinical decision making.
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spelling pubmed-62808902018-12-14 Impact of inflammatory markers on survival in patients with limited disease small-cell lung cancer undergoing chemoradiotherapy Bernhardt, Denise Aufderstrasse, Sophie König, Laila Adeberg, Sebastian Bozorgmehr, Farastuk Christopoulos, Petros Shafie, Rami A El Hörner-Rieber, Juliane Kappes, Jutta Thomas, Michael Herth, Felix Steins, Martin Debus, Jürgen Rieken, Stefan Cancer Manag Res Original Research BACKGROUND: Systemic inflammation appears to play a role in the progression of numerous solid tumors by promoting tumor proliferation. Our current study aimed to evaluate the role of inflammatory markers in limited disease (LD) small-cell lung cancer (SCLC) patients undergoing thoracic chemoradiotherapy (TCR). PATIENTS AND METHODS: We retrospectively analyzed a total number of 350 SCLC patients diagnosed with LD SCLC who received TCR between 1999 and 2017 and had available blood tests within 2 weeks prior to the start of TCR. Serum C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase (LDH), hemoglobin (Hb) levels, and platelet count (Pc) were evaluated as potential inflammatory markers. Kaplan–Meier survival analysis was performed for overall survival (OS). For comparison of survival curves, the log-rank (Mantel–Cox) test was used. Univariate and multivariate Cox proportional HRs were used to assess the influence of cofactors on OS. RESULTS: Univariate analysis for OS revealed a statistically significant effect for LDH >400 U/L (HR 2.05 U/L; 95% CI 1.29–3.26 U/L; P=0.002), prophylactic cranial irradiation (PCI; HR 0.58; 95% CI 0.40–0.85; P=0.005), CRP >50 mg/L (HR 1.49 mg/L; 95% CI 1.05–2.10 mg/L; P=0.026), and Karnofsky performance scale (KPS) <70% (HR 1.35%; 95% CI 1.02–1.80%; P=0.035). NLR, age (>70 years), Hb levels, and Pc did not influence survival. In multivariate analysis, OS was significantly affected by PCI (HR 0.64; 95% CI 0.43–0.94; P=0.026), LDH >400 U/L (HR 1.91 U/L; 95% CI 1.21–3.05 U/L; P=0.006), and CRP >50 mg/L (HR 1.43 mg/L; 95% CI 1.01–2.04 mg/L; P=0.045). KPS (≤70%) did not influence survival in multivariate analysis. CONCLUSION: Elevated CRP and LDH seem to be the independent prognostic factors for OS in LD SCLC patients undergoing TCR. However, elevated NLR was not found to be an independent prognostic factor for OS if taken prior to TCR. LDH and CRP are easily available blood tests and do not require additional resources for routine use and could be useful for clinical decision making. Dove Medical Press 2018-11-30 /pmc/articles/PMC6280890/ /pubmed/30555261 http://dx.doi.org/10.2147/CMAR.S180990 Text en © 2018 Bernhardt et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Bernhardt, Denise
Aufderstrasse, Sophie
König, Laila
Adeberg, Sebastian
Bozorgmehr, Farastuk
Christopoulos, Petros
Shafie, Rami A El
Hörner-Rieber, Juliane
Kappes, Jutta
Thomas, Michael
Herth, Felix
Steins, Martin
Debus, Jürgen
Rieken, Stefan
Impact of inflammatory markers on survival in patients with limited disease small-cell lung cancer undergoing chemoradiotherapy
title Impact of inflammatory markers on survival in patients with limited disease small-cell lung cancer undergoing chemoradiotherapy
title_full Impact of inflammatory markers on survival in patients with limited disease small-cell lung cancer undergoing chemoradiotherapy
title_fullStr Impact of inflammatory markers on survival in patients with limited disease small-cell lung cancer undergoing chemoradiotherapy
title_full_unstemmed Impact of inflammatory markers on survival in patients with limited disease small-cell lung cancer undergoing chemoradiotherapy
title_short Impact of inflammatory markers on survival in patients with limited disease small-cell lung cancer undergoing chemoradiotherapy
title_sort impact of inflammatory markers on survival in patients with limited disease small-cell lung cancer undergoing chemoradiotherapy
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6280890/
https://www.ncbi.nlm.nih.gov/pubmed/30555261
http://dx.doi.org/10.2147/CMAR.S180990
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