Serum albumin level as a potential marker for deciding chemotherapy or best supportive care in elderly, advanced non-small cell lung cancer patients with poor performance status

BMC Cancer

Research Article

Takashi Ogura¹  Akimasa Sekine¹  Takashi Niwa¹  Mitsunori Morita²  Tadashi Ishida²  Naoyuki Sone²  Satoshi Ikeo²  Akihiro Nishiyama²  Toshihide Yokoyama²  Hiroshige Yoshioka²  Satoshi Ikeda³ 

[1] Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Tomioka-Higashi 6-16-1, Kanazawa-ku, 236-0051, Yokohama-city, Japan;Department of Respiratory Medicine, Kurashiki Central Hospital, Miwa 1-1-1, 710-8602, Kurashiki-city, Japan;Department of Respiratory Medicine, Kurashiki Central Hospital, Miwa 1-1-1, 710-8602, Kurashiki-city, Japan;Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Tomioka-Higashi 6-16-1, Kanazawa-ku, 236-0051, Yokohama-city, Japan;

关键词: Non-small cell lung cancer;    Elderly;    Performance status;    Albumin;    Hypoalbuminemia;   

DOI  :  10.1186/s12885-017-3814-3

 received in 2017-08-10, accepted in 2017-11-21,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThere have been few data on the chemotherapy in elderly advanced non-small cell lung cancer (NSCLC) patients with poor performance status (PS), and usefulness of chemotherapy for such patients remains unclear. The objective of this study was to identify factors that predicted the survival benefit of chemotherapy.MethodsAll consecutive elderly patients (≥75 years) with advanced NSCLC, Eastern Cooperative Oncology Group PS ≥2, EGFR mutation wild type/unknown, and newly diagnosed from January 2009 to December 2012 at a tertiary hospital were retrospectively reviewed.ResultsWe enrolled 59 patients, and 31 patients received at least one chemotherapy regimen (chemotherapy group). However, 28 patients received best supportive care (BSC) alone (BSC group). The proportion of PS 2 and serum albumin levels was significantly higher in the chemotherapy group than in the BSC group. In the chemotherapy group, log-rank testing did not show statistically significant differences in overall survival (OS) between the single-agent therapy group and carboplatin-based doublet therapy group; however, the OS of patients receiving chemotherapy for only 1 cycle (early termination) was significantly shorter than patients receiving chemotherapy for ≥2 cycles. Hypoalbuminemia was not only a risk factor for the early termination of chemotherapy but also an independent prognostic factor in the chemotherapy group. A receiver operating characteristic curve analysis showed that the best cut-off value was 3.40 g/dL. In patients with serum albumin levels ≥3.40 g/dL, OS was significantly better in the chemotherapy group than in the BSC group (p = 0.0156), however, patients with serum albumin levels <3.40 g/dL exhibited poor prognosis regardless of the presence or absence of chemotherapy.ConclusionIn the elderly NSCLC patients with poor PS, serum albumin levels may help identify certain patient populations more likely to receive a survival benefit of systemic chemotherapy.

【 授权许可】

CC BY   
© The Author(s). 2017