The Prognostic Value Of ADR,AIR And AFR In Patients With Advanced Lung Adenocarcinoma Receiving Platinum-based Chemotherapy

Objective:The purpose of this experiment is to explore the efficacy and prognostic value of ADR,AIR and AFR in patients with advanced lung adenocarcinoma receiving platinum-based chemotherapy.Method:Retrospective analysis was used to select 89 patients with stage III or IV lung adenocarcinoma who were treated with PP or TP chemotherapy in the First Affiliated Hospital of Nanchang University from July 2020 to July 2022.The clinical data of the patients were collected.The albumin,D-dimer,international standardized ratio,fibrinogen index were collected and the ADR,AIR and AFR values were calculated.The ROC curve analysis was used to determine the optimal critical value of ADR,AIR and AFR.Chi-square test was used to analyze the efficacy;Kaplan-Meier method and Log-rank test were used for univariate analysis,and COX regression model was used for multivariate analysis of the efficacy and prognostic value of the above indicators in patients with advanced lung adenocarcinoma receiving platinum-based chemotherapy.Results:(1)According to the ROC curve and AUC,the cutoff values of ADR,AIR and AFR were 60.16,35.88 and 10.79.(2)Chi-square test showed that the ORR of H-ADR(ADR > 60.16)group and L-ADR(ADR ≤ 60.16)group were 46.88 % and 22.05 %,P = 0.011.DCR were93.75 % and 75.44 %,P = 0.010.The ORR of H-AIR group(AIR > 35.88)and L-AIR group(AIR ≤ 35.88)were 39.06 % and 8.00 %,(P = 0.004).DCR were89.06 % and 68.00 %,P = 0.017.The ORR of H-AFR group(AFR > 10.79)and L-AFR group(AFR ≤ 10.79)were 39.22 % and 18.42 %,(P = 0.035).DCR were90.20 % and 73.86 %,P = 0.040.(3)Univariate analysis showed that ADR,AIR,AFR,number of metastases,and ECOG score were associated with PFS and OS in patients with advanced lung adenocarcinoma(P < 0.05).(4)Multivariate analysis showed that ADR(HR = 0.450,P = 0.040),ECOG score(HR = 1.957,P = 0.028)and OS of patients with advanced lung adenocarcin-oma were all P < 0.05,and the difference was statistically significant.The number of metastases(PFS : HR = 1.863,P = 0.023;OS : HR = 2.177,P = 0.027)and PFS and OS in patients with advanced lung adenocarcinoma,the difference was statistically significant(P < 0.05).Conclusions:(1)ADR,AIR and AFR were significantly correlated with short-term efficacy,PFS and OS in patients with advanced lung adenocarcinoma receiving platinum-based chemotherapy.(2)ADR and ECOG scores were independent prognostic factors for OS in patients with advanced lung adenocarcinoma.The number of metastases is an independent prognostic factor for PFS and OS in patients with advanced lung adenocarcinoma.