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Predictive and prognostic factors in small cell lung carcinoma (SCLC)--analysis from routine clinical practice
Wolfgang M Brueckl1, Lara Herbst, Annette Lechler
1Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany. wolfgang.brueckl@med1.imed.unierlangen.de
Background:
Prognostic and predictive factors of routine clinical practice among patients with small cell lung carcinoma (SCLC) were evaluated.
Patients And Methods:
Data from 106 patients with SCLC treated by first-line adriamycin, cyclophosphamide and etoposide (ACE) chemotherapy were analyzed. Multivariate analysis was performed.
Results:
The median overall survival (mOS) of patients was 9.36 months with mOS of 31%, 8% and 3% after 1, 2 and 5 years, respectively. Using multivariate analysis ECOG performance status (p =0.008) and white blood count (WBC) (p=0.022) were independent prognostic factors for mOS. With both, three groups of outcome (good, intermediate, poor) resulting in mOS of 15.8 months, 6.87 months and 3.35 months (p<0.0001) could be established, respectively. The absence of brain metastases (p=0.002), dose reduction (p=0.002) and LDH value (p=0.017) were independent predictive markers. Additionally, female gender was predictive (p=0.025) for complete response (CR).
Conclusion:
Patients with a poor prediction profil might not benefit from ACE chemotherapy. As a consequence, prognostic/predictive factors should be included as stratification criteria in prospective clinical studies.
