Evre IV küçük hücreli dışı akciğer kanserli hastaların sağkalımını etkileyen faktörler

Turgut Kaçan; Nalan Akgül Babacan; Birsen Yücel; Saadettin Kılıçkap; Ebru Atasever Akkaş; Mehmet Şeker; Mehmet Eren; Ayfer Ay Eren

EN TR

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Abstract

Aim. The purpose of this study is to examine the prognostic factors effecting the survival of stage IV non-small cell lung cancer patients. Method. Demographic, clinical and histopathologic data from 2006 to 2011 were collected from non-small cell lung cancer patients who were treated in our clinic. With the permission of the patients who didn’t attend to routine follow-ups, their names were searched in identification interrogation system in order to use their identity information in survival analysis. In order to analyze frequency distributions, Mann-Whitney U test and KaplanMeier survival analysis were used. Results. A hundred (88%) male, 13 (12%) female of total 113 patients data were analyzed. The mean age was 62 (37-82). 90 (80%) of the patients were smokers, family history existed in 27 (24%) of the patients, 40 (35%) of patients were with comorbidities. According to the histopathological aspect; 24 (21%) patients were epidermoid, 30 (27%) adenocarsinoma, 3 (2%) neuroendocrine, 56 (50%) patients had unspecified non-small cell lung carcinoma. The most common Eastern Cooperative Oncology Group Perfromance Status was ECOG 1. Frequent sites of metastasis: 40 (35%) brain, 36 (32%) bone, 24 (21%) liver, 20 (18%) opposite lung. Chemotherapy was given to 83 (73%) patient whereas supportive therapy was given to 30 (27%) of the patients. Pain-killers were used in 84 (74%) patients, palliative radiotherapy was apllied to 69 (61%). Median follow-up was 8 months (1-47), median survival was 8 months. One-year overall survival was 35 Eastern Cooperative Oncology Group Perfromance Status (p<0.001), and chemotherapy (p<0.001), and usage of cisplatin (p<0.001) and docetaxel (p=0.043) during the treatment, increased levels of lactic dehydrogenase (p=0.007) were the prognostic factors effecting the survival. Chemotherapy (p<0.001) and high lactic dehydrogenase levels (p=0.004) were the independent prognostic factors. Conclusion. In stage IV non-small cell lung cancer the most important prognostic factors effecting the survival are chemotherapy and elevated lactic dehydrogenase levels.

Keywords

Stage IV non-small cell lung cancer, survival, prognosis

Evre IV küçük hücreli dışı akciğer kanserli hastaların sağkalımını etkileyen faktörler

Öz

Amaç. Bu çalışmada evre IV küçük hücreli dışı akciğer kanserli hastalarda tedavi öncesi prognostik faktörlerin sağkalım üzerine etkilerinin incelenmesi amaçlandı. Yöntem: Bu çalışma 2006-2011 tarihleri arasında merkezimize tedavi edilen evre IV küçük hücreli dışı akciğer kanserli 113 hastanın dosyalarının retrospektif incelenmesi ile yapıldı. Hastalara ait demografik, klinik ve histopatolojik veriler hasta dosya ve hastane kayıtları incelenerek elde edildi. Kontrole gelmemiş hastalar sağkalım analizi için, izin alınarak kimlik sorgulama sisteminde sorgulandı. Analiz için sıklık testleri, Mann-Whitney U testi ve Kaplan-Meier analizi kullanıldı. Bulgular. Yüzü (%88) erkek, 13'ü (%12) kadın toplam 113 hastanın verisi analiz edildi. Ortanca yaş 62 (37-82) idi. Sigara kullanımı 90 (%80) hastada, aile hikayesi 27 (%24) hastada, komorbidite 40 (%35) hastada mevcuttu. Histopatolojik alt tip olarak 24 (%21) hasta epidermoid, 30 (%27) hasta adenokarsinom, 3 (%2) hasta nöroendokrin alt tipine sahipti. Ellialtı (%50) hastanın ise histopatolojik alt tipi belirlenememişti. En sık rastalanan Eastern Cooperative Oncology Group Perfromance Statusu ECOG 1 idi. En sık metastaz yerleri beyin (%35), kemik (%32), karaciğer (%21) ve karşı akciğer (%18) idi. Hastaların 83'üne (%73) kemoterapi uygulanırken 30'una (%27) destek tedavisi verildi. Analjezik kullanımı 84 (%74) hastada var iken palyatif radyoterapi 69 (%61) hastaya uygulandı. Ortanca takip 8 ay (1-47), ortanca sağkalım 8 ay idi. Bir yıllık genel sağkalım %35 olarak tespit edildi. Eastern Cooperative Oncology Group Perfromance Statusu (p < 0,001), kemoterapi uygulaması (p < 0,001), tedavide cisplatin (p < 0,001) ve docetaxel (p=0,043) kullanımı, laktik dehidrogenaz yüksekliği (p=0,007) sağkalımı belirleyen prognostik faktörlerdi. Kemoterapi uygulaması (p < 0,001) ve laktik dehidrogenaz yüksekliği (p=0,004) ise bağımsız prognostik faktörlerdi. Sonuç. Evre IV küçük hücreli dışı akciğer kanserinde sağkalımı etkileyen en önemli prognostik faktörler hastaya kemoterapi uygulanması ve laktik dehidrogenaz yüksekliği olarak tespit edildi.

Anahtar Kelimeler

Evre IV küçük hücreli dışı akciğer kanseri, sağkalım, prognosis

Kaynakça

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Ayrıntılar

Birincil Dil

Türkçe

Konular

-

Bölüm

-

Yazarlar

Turgut Kaçan

Nalan Akgül Babacan

Birsen Yücel

Saadettin Kılıçkap

Ebru Atasever Akkaş

Mehmet Şeker

Mehmet Eren

Ayfer Ay Eren

Yayımlanma Tarihi

2 Şubat 2013

Gönderilme Tarihi

2 Şubat 2013

Kabul Tarihi

-

Yayımlandığı Sayı

Yıl 2013 Cilt: 35 Sayı: 3

IZ

https://izlik.org/JA26MK56DK

Kaynak Göster

RIS / Bibtex

AMA

1.Kaçan T, Akgül Babacan N, Yücel B, vd. Evre IV küçük hücreli dışı akciğer kanserli hastaların sağkalımını etkileyen faktörler. CMJ. 2013;35(3):332-338. https://izlik.org/JA26MK56DK