Multivariate Analysis Of Early Response To Platinum-based Chemotherapy In Advanced Non-small-cell Lung Cancer

Background and purpose : Primary lung cancer is originated in the bronchial epithelium and glands of the tumor, the most common malignant tumor and one of the highest mortality rate. Lung cancer is divided into small cell lung cancer and non-small cell lung cancer (non-small cell lung cancer, NSCLC), which NSCLC accounts for about 80% of lung cancer, although surgery is the treatment of choice for NSCLC, but about 80% of the patients diagnosed with inoperable when . Therefore, the poor prognosis of advanced NSCLC, 5-year survival of less than 15%. At home and abroad agreed that the two-drug combination with platinum chemotherapy is a joint program of advanced drug first-line standard treatment for lung cancer. However, two-drug combination with platinum chemotherapy in the treatment of advanced NSCLC with low efficiency and toxicity of the more obvious, so some patients with chemotherapy ineffective chemotherapy suffered a lot of unnecessary toxicity, it was necessary to find a can predict patients before chemotherapy therapeutic methods to guide individual treatment is very important. Scholars abroad that could affect the first-line platinum-based chemotherapy in the treatment of advanced NSCLC in early analysis of efficacy of relevant factors, may predict the efficacy and prognosis of the disease, but also through mathematical modeling statistical prognosis models, while still abroad Clinical prediction model without the establishment of the relevance of reports. 132 cases of this topic on the clinical efficacy of advanced NSCLC were retrospectively analyzed, summarized effects of platinum chemotherapy in the clinical effect of related factors, and through statistical software, and the establishment of effective prediction model for the prediction of platinum chemotherapy in the treatment of advanced clinical efficacy of early and prognosis of NSCLC, a reference to guide clinical treatment.Methods : Retrospective analysis from January 2004 to December 2009 in our hospital respiratory medicine or hematology-oncology hospital and pathology (bronchoscopy, lymph node or lung biopsy) or cytology (sputum exfoliated cells exfoliated cells or pleural effusion , 2, and these results match) confirmed, and completed two cycles of first-line platinum-based chemotherapy, chemotherapy prior to chest CT and the completion of 2 courses of platinum-based regimen, after 3 courses before the start of chest CT,â…¢B /â…£progress 132 cases of NSCLC patients, treatment options, including NP (NVB 25~30 mg/m2, 1, 8 days; DDP 75 ~ 80 mg/ m2, day 1), TP (PACLITAXOL 175 mg/ m2 or TAXOL 75 mg/ m2, 1 days; DDP 75 mg / m2, day 1) and GP (GEMZAR 1 000 mg / m2, 1, 8 days; DDP 80mg/ m2, day 1), DDP sometimes divided according to status of patients on day 1,2,both every 3 weeks for a course of treatment, a total of Line 2 courses. Among them, 15 cases radiotherapy, chemotherapy and radiotherapy for the simultaneous or sequential chemotherapy. According to evaluation of solid tumor RECIST criteria evaluated, with the target lesion before and after chemotherapy reduced or increased the proportion of non-target lesions and to evaluate the effect of the change. SPSS16.0 software applications to conduct likelihood ratio chi-square test and multiple Logistic regression analysis, age, gender, smoking, fever, weight loss, performance status (PS), T stage, pleural metastasis, N stage, supraclavicular lymph node metastasis, mediastinal lymph node metastasis, M stage, bone metastases, pericardial metastasis, TNM stage, pathological type, initial treatment, radiotherapy and surgery of single factor and multivariate analysis, Logistic regression results according to established first-line prediction early effects of platinum chemotherapy statistical model.Results : The general clinical data collection results: the youngest 31 years old, maximum 69 years, with a median age of 56.17 years; 85 male and 47 females, male to female ratio was 1.79:1; smokers of 63 cases, 69 cases of non-smokers; fever in 10 cases, no fever in 122 cases; thin 31 cases, no weight loss were 101 cases; PS score 0 points 43 cases, 89 were 1 score; local infiltration T1 9 cases, T2 37 cases, T3 8 cases, T4 73 cases, Tx 5 cases, including There were 52 cases of pleural metastasis; lymph node metastasis N0 23 cases, N1 1 cases, N2 24 cases, N3 74 cases, Nx 10 cases, including 35 cases of supraclavicular lymph nodes, mediastinal lymph node metastasis in 79 cases; distant metastasis Mx 1 case, M0 67 cases, M1 64 cases, including 27 cases of bone metastases, pericardial metastasis in 6; TNM stageâ…¢B, 67 cases,â…£of 65 cases; pathological type adenocarcinoma 50 cases, 82 cases of squamous cell carcinoma, squamous cell carcinoma gland cancer than 1.64:1; diagnosed in 103 patients, non-naive persons (retreatment) 29 cases; radiotherapy in 15 patients and 117 cases without radiotherapy; surgery in 24 patients, 108 patients without surgical; effect of CR 0 cases, PR 33 cases, SD 59 cases, PD 40 cases. According to likelihood ratio chi-square test and multiple Logistic regression analysis, the general status (PS score), T stage, TNM stage, initial treatment or not, radiation or other factors are in advanced NSCLC, first-line platinum chemotherapy efficacy the effect of significant differences (all P <0.05); the sex, age, smoking, fever, weight loss, surgery, pleural metastasis, N stage, supraclavicular lymph node metastasis, mediastinal lymph node metastasis, M stage, bone transfer, pericardial metastasis and pathological factors are considered advanced NSCLC first-line platinum-based chemotherapy in the curative effect of no significant difference (all P> 0.05); and apply the Wald test are introduced into the model of variable and constant coefficient (B) and related data, the effect of three sets of data (PR, SD, PD) through the process of building two Multinomal logistic logit model, Logistic equation statistical test correctly judge the efficacy of its accuracy rate of 68.2%.Conclutions :â…¢B /â…£advanced NSCLC, platinum-based chemotherapy for first-line early efficacy and general condition (PS score), T stage, TNM stage, initial treatment, radiotherapy, but not with age,sex, smoking, fever, weight loss, N stage, M stage, supraclavicular lymph node metastasis, mediastinal lymph node metastasis, pleural metastasis, bone metastases,pericardial metastasis , pathological type and surgery and other factors not related. logistic statistical equation to predict a certain extent, first-line platinum-based chemotherapy efficacy purposes.