Screening for Patients with Non-small Cell Lung Cancer Who Could Survive Long Term Chemotherapy


Background: Lung cancer was one of the most common cancers in both men and women all over the world.In this study, we aimed to clarify who could survive after long term chemotherapy in patients with advancednon-small cell lung cancer (NSCLC).
Methods: We enrolled 186 patients with stage IV NSCLC after long termchemotherapy from Jun 2006 to Nov 2014 diagnosed in Jiangsu Cancer Hospital. Multiple variables like age,gender, smoking, histology of adenocarcinoma and squamous-cell cancer, number of metastatic sites, metastaticsites (e.g. lung, brain, bone, liver and pleura), hemoglobin, lymphocyte rate (LYR), Change of LYR during multipletherapies, hypertension, diabetes, chronic bronchitis, treatments (e.g.radiotherapy and targeted therapy) wereselected. For consideration of factors influencing survival and response for patients with advanced NSCLC,logistic regression analysis and Cox regression analysis were used in an attempt to develop a screening modulefor patients with elevated survival after long term chemotherapy become possible.
Results: Of the total of 186patients enrolled, 69 survived less than 1 year (short-term group), 45 one to two years, and 72 longer than 3years (long-term group). For logistic regression analysis, the short-term group was taken as control group andthe long-term group as the case group. We found that age, histology of adenocarcinoma, metastatic site (e.g. lungand liver), treatments (e.g. targeted therapy and radiotherapy), LYR, a decreasing tendency of LYR and chronicbronchitis were individually associated with overall survival by Cox regression analysis. A multivariable Coxregression model showed that metastatic site (e.g. lung and liver), histology of adenocarcinoma, treatments (e.g.targeted therapy and radiotherapy) and chronic bronchitis were associated with overall survival. Thus metastaticsite (e.g. lung and liver) and chronic bronchitis may be important risk factors for patients with advanced NSCLC.Gender, metastatic site (e.g. lung and liver), LYR and the decreasing tendency of LYR were significantly associatedwith long-term survival in the individual-variable logistic regression model (P<0.05). On multivariate logisticregression analysis, gender, metastatic site (e.g. lung and liver) and the decreasing tendency of LYR associatedwith long-term survival.
Conclusions: In conclusion, female patients with stage IV adenocarcinoma of NSCLCwho had decreasing tendency of LYR during the course therapy and had accepted multiple therapies e.g. morethan third-line chemotherapy, radiotherapy and/or targeted therapy might be expected to live longer.