ÖZET
Amaç:
Yaygın evre-küçük hücreli akciğer kanseri (ES-SCLC) tanılı olup, ilk basamakta sisplatin ve etoposid kombinasyon kemoterapisi alan hastalarda tedaviye tam yanıtı (CR) etkileyen faktörleri ve tedaviye yanıt düzeyinin sağkalıma etkisini araştırdık.
Yöntem:
Bu retrospektif çalışmada ES-SCLC tanılı 140 hasta incelendi. İlk basamak kemoterapi sonrası radyolojik yanıt değerlendirmesine göre CR ve CR olmayan (non-CR) olarak iki grup belirlendi. Klinik, demografik hasta özellikleri ve tedavi öncesi hemogram parametreleri arşivden elde edildi.
Bulgular:
Hastaların 34’ü (%24,3) CR, 106 (%75,7) hasta non-CR grubunda yer aldı. Yapılan tek değişkenli analizde tanı anında beyin metastazı yokluğu, 6 kemoterapi siklusu alma ve iyi performans durumu CR için öngörücü faktörler olarak bulundu (sırasıyla p<0,001; p=0,020; p=0,001). Çok değişkenli analizde ise beyin metastaz yokluğu ve iyi performans durumu CR için bağımsız prediktif faktörler olarak saptandı (sırasıyla p=0,033; p=0,019). Ayrıca birinci basamak kemoterapiye verilen yanıt arttıkça hastalıksız sağkalım süresi ve genel sağkalım süresinin uzadığı tespit edildi (sırasıyla log-rank p<0,001; log-rank p<0,001).
Sonuç:
Tanı anında beyin metastaz yokluğu ve iyi performans durumu birinci basamak tedaviye tam yanıt için bağımsız prediktif faktörlerdir. Tam yanıta ulaşan hastalar, daha düşük tedavi yanıtına göre önemli ölçüde daha uzun sağkalıma sahiptir.
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