| Purpose:This study retrospectively analyzes the bone marrow suppression after chemot-herapy in patients with small cell lung cancer in our hospital and related clinical data.To assess the association between timing and severity of Chemotherapy Induced Neutropenia(CIN)on the survival prognosis of patients with small cell lung cancer(SCLC)after chemotherapy and to further analyze the related risk factors affecting the survival prognosis of SCLC patients.Patients and Methods:Between January 2015 to December 2017,121 patients with small-cell lung cancer who received at least 4 cycles of chemotherapy in the Department of oncology,the First Affiliated Hospital of Nanchang University were included in the study.This study assessed the relationship between the time,severity,and prognosis of neutron-penia after chemotherapy in these patients.According to the sequence of occurrence of myelosuppression,patients with CIN within two cycles of chemotherapy were defined as early-onset,while those without CIN within two cycles were defined as non-early-onset.SPSS Statistics 25.0 was utilised to conduct statistical analysis on the survival conditions(PFS and OS)of patients in the two groups.The correlation between the occurrence of CIN and survival rate was investigated with Kaplan-Meier method and Cox Proportional Risk Model.Kaplan-Meier method was used for univariate analysis of factors that may affect survival and prognosis,and COX regression(Forward:LR method)was used for multivariate analysis.P<0.05 was considered statistically significant.Results:1.A total of 121 patients with small cell lung cancer were included in this study,which were divided into two groups according to the presence or absence of leukopenia,among which 110 patients showed leukopenia(90.9%)and 11 patients did not show leukopenia(9.1%).The median PFS of the two groups was 7.6 monthsand 10.0 months,respectively(P < 0.05),and the difference was statistically significant.The median OS was 17.9 months and 18.6 months,respectively(P > 0.05),and the difference was not statistically significant.According to the presence or absence of CIN in patients,there were 2 groups,23 patients(19%)did not show CIN,98 patients(81%)showed CIN,the median OS was 16.7 months and 18.8 months,respectively(P > 0.05),the difference was not statistically significant.The median PFS was 8.0 months and 7.4 months,and the median PFS of patients without CIN was slightly less than those without CIN(P > 0.05),with no statistical significance.2.According to the severity of leukocyte decline,the patients were divided into three groups,78 cases(54.5%)showed mild(grade 1-2)leukocyte decline,and 32cases(26.4%)showed severe(grade 3-4)leukocyte decline.The median PFS was10.0 months,7.4 months and 7.8months,respectively(P > 0.05),and the difference was not statistically significant.The median OS was 18.6 months,18.1 and 16.8months(P > 0.05),respectively,and the difference was not statistically significant.According to the classification of CIN severity,patients were divided into three groups: 23 cases without CIN(19.0%),69 cases with mild(grade 1-2)CIN(57.0%),and 29 cases with severe(grade 3-4)CIN(24.0%).The median PFS was 8.0 months,7.4 months and 7.6 months(P=0.360),respectively.The median OS was 16.7 months,19.6 months and 17.9 months,respectively.Although the median OS of patients in the mild CIN group was longer than those in the other two groups(P=0.581),the difference was not statistically significant.3.According to the presence or absence of neutropenia(CIN)within 2 cycles of chemotherapy,it was divided into early-onset and non-early-onset CIN.There were74 patients(61.2%)with early-onset CIN and 47 patients(38.8%)with non-early CIN.The median PFS was 7.8 months and 7.6 months,respectively(P>0.05).The difference was not statistically significant.The median OS was 20.1 months and 15.8months(P<0.05),and the difference was statistically significant.4.Kaplan-Meier survival analysis showed that factors such as ECOG,baseline leukocyte,radiotherapy,and leukopenia had an effect on PFS.Multivariate COX regression(Forward: LR method)showed that ECOG and radiotherapy were independent influencing factors of PFS.5.Kaplan-Meier survival analysis showed that factors such as ECOG,NSE,staging,CIN appearance time had an effect on OS.Multivariate COX regression(Forward: LR method)showed that the appearance time of ECOG,NSE,staging,and time of CIN was an independent influencing factor of OS.Conclusion:The time of CIN is an independent predictor of prognosis in patients with small cell lung cancer after treatment.Early onset bone marrow suppression predicts better survival. |
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