The Influence Factor Of Progression-Free Survival In Patients With Metastatic Non-Small Cell Lung Cancer Who Received First-Line Platinum-based Chemotherapy

Purpose: The aim of this study is to investigate the influence factor of progression-free survival in patients with metastatic non-small cell lung cancer(NSCLC)treated with first-line platinum-based chemotherapy.Patients and Methods: A total of 98 patients of metastatic non-small cell lung cancer newly diagnosed at our hospital between January 2010 and December 2016 were retrospectively recruited for analysis,according to the inclusion and exclusion criteria.All patients received first-line platinum-based chemotherapy and accepted PET-CT examination before treatment.The clinicopathological information of the patients,the PET-CT metabolic parameters and peripheral inflammatory indexes of the primary and metastatic lesions before treatment were collected.SPSS 19.0 program was used for statistical analysis,and a two-side P<0.05 was considered statistical significant.The patients were divided into low and high group according to median of continuous variable.Using chi-square test or Fishers exact to analyze the statistical differences between the groups,logistic regression analysis was performed to analyze the factors that may affect the response of patients.Kaplan-Meier analysis and log-rank test were used to compare the differences in survival distributions between groups,and Cox regression model was used for multivariate analysis.Results: The patients were divided into low and high group according to median of absolute lymphocyte count(ALC),lymphocytes to monocytes ratio(LMR),neutrophils to lymphocytes ratio(NLR)(ALC =2.02,LMR=2.42,NLR=2.66).Univariate results showed that ALC level before chemotherapy was correlated with smoking(p=0.043),and response(p=0.039).LMR level was correlated with patient age(p=0.008),pathological type(p=0.035),number of metastatic lesions(p=0.027),SUVmax of metastatic lesions(p=0.002),chemotherapy regimens(p=0.034)and response(p=0.025).no significant correlation was found with NLR level.Univariate analysis showed that age(p=0.012),number of metastatic organs(p=0.087),and number of metastatic lesions(p=0.035)were correlated with short-term efficacy.Multivariate regression analysis showed that number of metastatic lesions(p=0.046)was an independent factor affecting short-term efficacy of patients with metastatic NSCLC receiving standard chemotherapy.In the survival analysis,univariate analysis showed that clinical T staging,ALC level,and response were correlated with the PFS of metastatic NSCLC receiving standard chemotherapy.Multivariate analysis showed that the clinical T stage(p=0.010,HR=0.271;95%CI:0.101-0.730),ALC level(p=0.043,HR=4.524;95%CI: 1.048-19.534),response(p=0.006,HR=0.129;95%CI:0.031-0.548)is an independent prognostic factor affecting the PFS of metastatic NSCLC.Conclusion: In this study,Univariate analysis showed that age(p=0.012),number of metastatic organs(p=0.087),and number of metastatic lesions(p=0.035)were correlated with short-term efficacy.Multivariate regression analysis showed that number of metastatic lesions(p=0.046)was an independent factor affecting short-term efficacy of patients with metastatic NSCLC receiving standard chemotherapy.In the survival analysis,univariate analysis showed that clinical T stage,ALC level,and response were correlated with the PFS of metastatic NSCLC receiving standard chemotherapy.Cox multivariate analysis showed that clinical T stage,ALC level before chemotherapy and response were independent prognostic factors affecting PFS of advanced non-small cell lung cancer.Earlier clinical T stage,higher ALC level before chemotherapy and good response are related to the longer PFS after chemotherapy for advanced non-small cell lung cancer.