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A new prognostic score based on the systemic inflammatory response in patients with inoperable non-small-cell lung cancer

Authors Zhu L, Li X, Shen Y, Cao Y, Fang X, Chen J, Yuan Y

Received 26 February 2016

Accepted for publication 9 June 2016

Published 8 August 2016 Volume 2016:9 Pages 4879—4886

DOI https://doi.org/10.2147/OTT.S107279

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Ram Prasad

Peer reviewer comments 2

Editor who approved publication: Professor Min Li


Lizhen Zhu,1 Xiaofen Li,1 Yanwei Shen,1 Ying Cao,1 Xuefeng Fang,1 Jiaqi Chen,1 Ying Yuan1,2

1Department of Medical Oncology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People’s Republic of China; 2Cancer Institute, Key Laboratory of Cancer Prevention and Intervention, Chinese National Ministry of Education, Hangzhou, Zhejiang Province, People’s Republic of China

Purpose: Pretreatment systemic inflammatory response has been confirmed to have prognostic value in patients with inoperable non-small-cell lung cancer (NSCLC). Increasing studies show that the modified Glasgow prognostic score (mGPS), a prognostic score based on C-reactive protein (CRP) and albumin, is a prognostic factor in these patients. This study was aimed at recognizing possible prognostic factors and new prognostic scores of inoperable NSCLC based on pretreatment systemic inflammatory response.
Patients and methods: We retrospectively reviewed the clinicopathological data of 105 patients with inoperable NSCLC who received first-line chemotherapy as initial treatment. Univariate and multivariate analyses of progression-free survival (PFS) and overall survival (OS) for prognostic factors and scores were performed.
Results: The serum CRP, lactate dehydrogenase (LDH), cancer antigen 125 (CA125), and pathological type were independent pretreatment prognostic factors for PFS and OS. A new score was assembled by CRP, LDH, and CA125. In multivariate analysis, when the mGPS and the new score were covariates, only the new score retained independent prognostic value for both PFS (P<0.001; hazard ratio =2.12; 95% confidence interval: 1.60–2.82) and OS (P<0.001; hazard ratio =1.82; 95% confidence interval: 1.33–2.48).
Conclusion: The new score based on pretreatment serum level of CRP, LDH, and CA125, indicates the prognosis of both PFS and OS in patients with inoperable NSCLC who were treated with first-line systemic chemotherapy, and it was found to be more effective than mGPS.

Keywords: C-reactive protein, lactate dehydrogenase, CA125 antigen, prognostic score

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