期刊
LUNG CANCER
卷 77, 期 3, 页码 545-549出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.lungcan.2012.04.019
关键词
Chemotherapy; Non-small cell lung cancer; Performance status; Survival; Advanced stage; Guidelines
资金
- Fund for Henry Ford
- National Cancer Institute at the National Institutes of Health [NIH R01 CA114204, R01 CA116227, R01 CA106370]
- Student Award Program from the Blue Cross and Blue Shield of Michigan Foundation [1705.SAP]
- Cancer Care Quality Training Program through the National Cancer Institute at the National Institutes of Health [R25 CA116339]
- American Cancer Society [PEP-10-174-01]
Background: Performance status (PS) is a commonly used factor in determining the appropriateness for chemotherapy of patients with non-small cell lung cancer (NSCLC). The prevalence of poor PS and impact of chemotherapy on survival among NSCLC patients has not been studied in community populations. Patients and methods: Insured patients, aged 50+ years, diagnosed with advanced stage NSCLC between 2000 and 2007 were identified via tumor registry (n = 292) and linked to electronic medical records, automated medical claims, and Census tract information. A multivariate Cox proportional hazards model was used to determine the factors associated with survival. Results: Of 292 stage IIIB-IV patients, 82(28%) had PS 3 or 4, and 39% of PS 3-4 patients received first line chemotherapy. Those who received chemotherapy lived 4.8 months compared to 2.4 months for those who did not. Factors associated with a reduced likelihood of death included receipt of chemotherapy (hazard ratio [HR], 0.64), and female gender (HR, 0.71). Modern chemotherapy may be associated with positive effects on survival for poor PS patients, as for good PS patients. Further trials, especially randomized trials, in this neglected subgroup are indicated. (c) 2012 Elsevier Ireland Ltd. All rights reserved.
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