| Objective:Survival analysis was performed to research whether serum sodium levels may predict the prognosis of patients with small cell lung cancer;to discuss the relationship between clinical features and hyponatremia in patients with SCLC.Methods:A retrospective study of 310 small cell lung cancer patients whom were confirmed by pathology or cytology from September 2009 to September 2015 in our hospital cancer center was performed.According to the level of serum sodium at their first visit and the lowest during chemotherapy,the patients were divided into low sodium group and normal group respectively.To research the correlation between the level of serum sodium and gender,age,smoking status,ECOG score,clinical stage,chemotherapy regimen,superior vena cava syndrome,and brain metastasis.Follow up progress time and death time by medical record system or telephone.The data was analyzed using SPSS19.0 statistical software,the data between two groups using t test or rank sum test,the data among multiple groups using analysis of variance or nonparametric test,survival analysis using Kaplan-Meier method.P < 0.05 was statistically significant.Results:1.There were 50 cases with hyponatremia at their first visit among 310 patients with SCLC,accounting for about 16.13%,70% of them suffered from moderate or severe hyponatremia;there were 127 patients suffered from hyponatremia from their first visit to the first line chemotherapy,accounting for 40.97% of the total number of patients.2.Compared the low sodium group at patient's first visit with the normal group,age,gender,smoking status,ECOG score,clinical stage,superior vena cava syndrome,brain metastasis were not statistically significant(P > 0.05).compared the lowest sodium group with the normal group,EP regimen was more likely to cause hyponatremia(P = 0.002)and there were no significant differences in other clinical features between two groups(P > 0.05).3.The median PFS was 7.63 months(95%CI:5.68~9.58 months)in low sodium group and the normal group's was 10.00 months(95%CI:8.98~11.02 months)at their first visit,having a statistically significant difference(P = 0.027);the median OS in low sodium group was 14.97 months(95%CI:13.53~16.39 months)and the normal group's was 19.80 months(95%CI:18.65~20.95 months),having a statistically significant difference too(P = 0.005).4.The median PFS of the lowest sodium group was 8.73 months(95%CI:7.65~9.82 months)and the normal group's was 10.20 months(95%CI:8.86~11.54 months),having a statistically significant difference(P = 0.036);the median OS of the low sodium group was 18.00 months(95%CI:14.35~21.66 months)and the normal group's was 19.7 months(95%CI:18.37~21.03 months),having no statistically significant difference between the two groups(P = 0.255).Conclusions:1.The incidence of hyponatremia in the patients with small cell lung cancer at their first visit was 16.13%,the incidence of hyponatremia after chemotherapy was significantly higher.2.EP regimen was more likely to cause hyponatremia during the first line therapy.3.Hyponatremia dignosed at their first visit was an independent risk factor for poor prognosis in patients with SCLC,and the lowest level of sodium during the first line chemotherapy has no significant correlation with overall survival. |
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