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第60巻第1号目次 | Japanese/English |
 | Full Text of PDF (152K) Article in Japanese |
─ 原著 ─
The Clinical Impact of the Post-progression Survival on the Overall Survival in Elderly Patients or Those with a Poor Performance Status and Extensive-disease Small-cell Lung Cancer
Satoshi Igawa1, Masanori Yokoba2, Tomoya Fukui1, Jiichiro Sasaki3, Katsuhiko Naoki11Department of Respiratory Medicine, Kitasato University School of Medicine, Japan, 2School of Allied Health Sciences, Kitasato University, Japan, 3Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, Japan
Objective. The post-progression survival (PPS) following first-line chemotherapy has been shown to influence the overall survival (OS) of patients with malignant diseases, including lung cancer. The aim of this study was to compare the influence of the PPS on the OS of elderly or poor performance status (PS) patients with extensive-disease small-cell lung cancer (ED-SCLC) to that of the progression-free survival (PFS) on the OS. Methods. The medical records of patients with ED-SCLC who were elderly (≥70 years old) or had a poor PS and who received chemotherapy between March 2010 and December 2017 were retrospectively reviewed. Seventy-five such patients who were treated with carboplatin-based chemotherapy or amrubicin monotherapy as first-line intervention were included, and the relationships between the OS and the PFS and PPS were analyzed. Results. The median age of the 75 patients was 72 years old. The median PFS and OS intervals were 6.1 and 11.8 months, respectively. Spearman's rank correlation and linear regression analyses showed that the PPS was more strongly correlated with the OS (r = 0.91, R2 = 0.83, P = 0.0001) than with the PFS (r = 0.81, R2 = 0.65, P = 0.017). In the multivariate analysis, a good PS, using carboplatin-based chemotherapy as the first-line chemotherapy, achieving a response to first-line chemotherapy, and implementation of second-line chemotherapy were independent favorable predictors of the PPS. Conclusion. The PPS after first-line chemotherapy has a strong impact on the OS in elderly or poor PS patients with ED-SCLC. Given the findings of this study, the development of novel anti-cancer drugs that are effective against SCLC is warranted to improve the PPS in such patients.
索引用語：Small-cell lung cancer, Elderly patients, Poor performance status, Post-progression survival
受付日：August 9, 2019
受理日：October 27, 2019
肺癌 60 (1)：10─16，2020
