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Abstract：
BACKGROUND: Small-cell lung cancer (SCLC) is a leading cause of cancer-related death. However, the prognostic value of the tumor shrinkage rate (TSR) after chemotherapy for SCLC is still unknown.
METHODS: We performed a retrospective analysis of 235 patients with SCLC. The TSR cutoff was determined based on receiver-operating characteristic curve analysis. The associations of TSR with progression-free survival (PFS) and overall survival (OS) were assessed using univariate and multivariate Cox proportional hazards models. Survival curves were obtained by the Kaplan-Meier method and compared using the log-rank test. Recurrence patterns after first-line treatment were summarized in a pie chart. A nomogram was constructed to validate the predictive role of the TSR in SCLC.
RESULTS: The TSR cutoff was identified to be - 6.6%. Median PFS and OS were longer in the group with a TSR < -6.6% than in the group with a TSR ≥ - 6.6%. PFS and OS were also longer in patients with extensive SCLC when the TSR was < - 6.6% than when it was > - 6.6%. Brain metastasis-free survival was better in the group with a TSR < - 6.6%. There was a significant positive correlation between TSR and PFS. Furthermore, univariate and multivariate regression analyses showed that the TSR, patient age, and previous radiotherapy were independent prognostic factors for OS while TSR and M stage were independent prognostic factors for PFS.
CONCLUSIONS: The TSR may prove to be a good indicator of OS and PFS in patients receiving chemotherapy-based first-line treatment for SCLC.
METHODS: We performed a retrospective analysis of 235 patients with SCLC. The TSR cutoff was determined based on receiver-operating characteristic curve analysis. The associations of TSR with progression-free survival (PFS) and overall survival (OS) were assessed using univariate and multivariate Cox proportional hazards models. Survival curves were obtained by the Kaplan-Meier method and compared using the log-rank test. Recurrence patterns after first-line treatment were summarized in a pie chart. A nomogram was constructed to validate the predictive role of the TSR in SCLC.
RESULTS: The TSR cutoff was identified to be - 6.6%. Median PFS and OS were longer in the group with a TSR < -6.6% than in the group with a TSR ≥ - 6.6%. PFS and OS were also longer in patients with extensive SCLC when the TSR was < - 6.6% than when it was > - 6.6%. Brain metastasis-free survival was better in the group with a TSR < - 6.6%. There was a significant positive correlation between TSR and PFS. Furthermore, univariate and multivariate regression analyses showed that the TSR, patient age, and previous radiotherapy were independent prognostic factors for OS while TSR and M stage were independent prognostic factors for PFS.
CONCLUSIONS: The TSR may prove to be a good indicator of OS and PFS in patients receiving chemotherapy-based first-line treatment for SCLC.
摘要：
背景：小细胞肺癌（SCLC）是癌症相关死亡的主要原因。然而,SCLC化疗后肿瘤收缩率(TSR)的预后价值尚不清楚.
方法：我们对235例SCLC患者进行了回顾性分析。基于接收器工作特性曲线分析确定TSR截止值。使用单变量和多变量Cox比例风险模型评估TSR与无进展生存期（PFS）和总生存期（OS）的相关性。通过Kaplan-Meier方法获得存活曲线，并使用对数秩检验进行比较。一线治疗后的复发模式总结在饼图中。构建列线图以验证TSR在SCLC中的预测作用。
结果：确定TSR截止值为-6.6%。TSR<-6.6％的组的中位PFS和OS长于TSR≥-6.6％的组。当TSR<-6.6％时，广泛性SCLC患者的PFS和OS也比其>-6.6％时更长。TSR<-6.6％的组无脑转移生存率更好。TSR与PFS呈显著正相关。此外，单因素和多元回归分析表明，TSR，患者年龄,和既往放疗是OS的独立预后因素，而TSR和M分期是PFS的独立预后因素。
结论：TSR可能是SCLC一线化疗患者OS和PFS的良好指标。
方法：我们对235例SCLC患者进行了回顾性分析。基于接收器工作特性曲线分析确定TSR截止值。使用单变量和多变量Cox比例风险模型评估TSR与无进展生存期（PFS）和总生存期（OS）的相关性。通过Kaplan-Meier方法获得存活曲线，并使用对数秩检验进行比较。一线治疗后的复发模式总结在饼图中。构建列线图以验证TSR在SCLC中的预测作用。
结果：确定TSR截止值为-6.6%。TSR<-6.6％的组的中位PFS和OS长于TSR≥-6.6％的组。当TSR<-6.6％时，广泛性SCLC患者的PFS和OS也比其>-6.6％时更长。TSR<-6.6％的组无脑转移生存率更好。TSR与PFS呈显著正相关。此外，单因素和多元回归分析表明，TSR，患者年龄,和既往放疗是OS的独立预后因素，而TSR和M分期是PFS的独立预后因素。
结论：TSR可能是SCLC一线化疗患者OS和PFS的良好指标。
