The Study Of Correlation Between Tumor Growth Rate(TGR) And Clinicopathological Features As Well As Prognosis In Advanced Non-small Cell Lung Cancer

Objective:The purpose of the study is to analyze the relationship between tumor growth rate(TGR)and clinicopathological features and prognosis in advanced non-small cell lung cancer(NSCLC).Methods:In this study,458 patients with advanced non-small cell lung cancer(NSCLC)who never get radiotherapy or surgery were included.The clinicopathological data were collected retrospectively,the sum of the maximum diameter of the target lesions at baseline and the first evaluation was measured,and tumor growth rate(TGR)was calculated by a formula.According to the different treatment options,overall population can be divided into chemotherapy group and targeted therapy group,we analyze the relationship between tumor growth rate(TGR)and clinicopathological features such as gender,age,smoking history,family history of cancer,ECOG score,pathological type,histological grade,KI67 index,EGFR gene status,tumor size(T),lymph node metastasis(N),clinical stage and so on.The progression-free survival(PFS)and overall survival(OS)were analyzed by Kaplan-Meier survival curve.Univariate and multivariate analyses using COX risk proportional regression model were performed to show the effect of TGR on the prognosis of different groups.Results:A total of 458 patients in general population were enrolled.The TGR was correlated with age,EGFR gene status,first-line treatment regimen.The patients with high TGR were mostly elderly(P=0.038),wild-type EGFR(P=0.013),chemotherapy(P=0.002).A total of 295 patients in the chemotherapy group and 163 patients in the targeted treatment group were enrolled,the correlation between TGR and clinicopathological features was not statistically significant.Survival analysis results showed that TGR had good predictive value for PFS and OS in the general population,chemotherapy group and targeted treatment group.In the general population median PFS in low TGR group was 8.7 months,and the median PFS in high TGR group was 4.2 months(P<0.001);median OS was 24.6 months in low TGR group and 16.4 months in high TGR group(P<0.001).The PFS and OS in low TGR group were significantly better than high TGR group.In the chemotherapy group,median PFS is 6.6 months in low TGR group and 3.9 months in high TGR group(P<0.001);median OS is 21.3 months in low TGR group and 14.5 months in high TGR group(P<0.001).The PFS and OS of the low TGR group were significantly better than high TGR group.In the targeted group,12.5 months in low TGR group,and 8.6 months in high TGR group(P=0.001);the median OS did not reach in low TGR group;the median OS was 17.7 months in high TGR group,(P<0.001).The PFS and OS in low TGR group were significantly better than that in high TGR group.COX regression analysis showed that low TGR could be used as an independent protective factor for PFS and OS in the general population and chemotherapy group.Conclusion:Tumor growth rate(TGR)is correlated with age,EGFR gene status,first-line treatment regimen in general population and has good prognostic value in general population and different treatment groups.The survival time of high TGR patients is shorter than that of low TGR patients.High TGR can be used as an independent risk factor for PFS and OS in the general population and the chemotherapy group.