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Ji Y, Wang W. Prognostic Value of the Gustave Roussy Immune Score in Lung Cancer: A Meta-Analysis. Nutr Cancer 2024:1-10. [PMID: 38841900 DOI: 10.1080/01635581.2024.2361508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 05/24/2024] [Indexed: 06/07/2024]
Abstract
PURPOSE To clarify the prognostic role of the Gustave Roussy immune (GRIm) score in lung cancer. METHODS The PubMed, Embase, Web of Science, and China National Knowledge Infrastructure databases were searched up to March 30, 2024. The primary outcomes included overall survival (OS) and progression-free survival (PFS). Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to evaluate the associations between the GRIm score and survival, and subgroup analyses were performed based on pathological type (non-small cell lung cancer vs. small cell lung cancer), tumor stage (advanced vs. limited stage) and treatment approach (immune checkpoint inhibitor vs. surgery vs. chemotherapy). RESULTS Eight studies with 1,333 participants were included. The pooled results showed that a higher GRIm score predicted worse OS (HR = 1.96, 95% CI: 1.54-2.49, P < 0.001) and PFS (HR = 1.64, 95% CI: 1.22-2.21, P = 0.001). Subgroup analyses for OS and PFS showed similar results. However, subgroup analyses for PFS indicated that the association between the GRIm score and PFS was nonsignificant among patients with small cell lung cancer (P = 0.114) and among patients treated with chemotherapy (P = 0.276). CONCLUSION The GRIm score might serve as a novel prognostic factor for lung cancer. Additional studies are still needed to verify these findings.
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Affiliation(s)
- Yanli Ji
- Department of Thoracic Surgery, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Wenping Wang
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
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Dawe DE, Rittberg R, Syed I, Shanahan MK, Moldaver D, Bucher O, Galloway K, Reynolds K, Paul JT, Harlos C, Kim JO, Banerji S. Real-world predictors of survival in patients with limited-stage small-cell lung cancer in Manitoba, Canada. Front Oncol 2023; 13:1191920. [PMID: 38125937 PMCID: PMC10731283 DOI: 10.3389/fonc.2023.1191920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 11/03/2023] [Indexed: 12/23/2023] Open
Abstract
Background Although therapy for limited-stage small-cell lung cancer (LS-SCLC) is administered with curative intent, most patients relapse and eventually die of recurrent disease. Chemotherapy (CT) with concurrent radiotherapy (RT) remains the standard of care for LS-SCLC; however, this could evolve in the near future. Therefore, understanding the current prognostic factors associated with survival is essential. Objective This real-world analysis examines factors associated with long-term survival in patients with LS-SCLC treated with CT in Manitoba, Canada. Methods A retrospective cohort study was conducted using Manitoba Cancer Registry and CancerCare Manitoba records. Eligible patients were aged >18 years and had cytologically confirmed LS-SCLC diagnosed between January 1, 2004, and December 31, 2018, for which they received CT ± RT. Baseline patient, disease, and treatment characteristics and survival duration, characterized as short (<6 months), medium (6-24 months), and long term (>24 months), were extracted. Overall survival (OS) was estimated at one, two, and five years and assessed using Kaplan-Meier methods and Cox proportional hazards models. Results Over the 15-year study period, 304 patients met the eligibility criteria. Long-term survivors comprised 39.1% of the cohort; at diagnosis, this subgroup was younger, more likely to have Eastern Cooperative Oncology Group Performance Status (ECOG PS) 0, and have normal lactate dehydrogenase, sodium, and hemoglobin levels. OS estimates for the entire cohort at one, two, and five years were 66%, 38%, and 18%, respectively. In the ECOG PS 0 subgroup, OS estimates at one, two, and five years were 85%, 52%, and 24%, respectively; OS estimates were 60%, 35%, and 17%, respectively, for ECOG PS 1-2 and were 47%, 23%, and 10%, respectively, for ECOG PS 3-4. OS was significantly higher among patients with normal serum sodium and hemoglobin levels than those with abnormal levels. Univariable hazard regression models found that ECOG PS, age at diagnosis, receipt of prophylactic cranial irradiation (PCI), and thoracic RT were associated with survival. On multivariable hazard regression, ECOG PS and receipt of PCI were associated with survival. Conclusion Survival for greater than two years in patients with LS-SCLC treated with CT ± RT was associated with ECOG PS and receipt of PCI.
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Affiliation(s)
- David E. Dawe
- Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
- Department of Hematology and Medical Oncology, CancerCare Manitoba, Winnipeg, MB, Canada
- CancerCare Manitoba Research Institute, CancerCare Manitoba, Winnipeg, MB, Canada
| | - Rebekah Rittberg
- Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
- Department of Hematology and Medical Oncology, CancerCare Manitoba, Winnipeg, MB, Canada
| | - Iqra Syed
- AstraZeneca Canada, Mississauga, ON, Canada
| | | | | | - Oliver Bucher
- Department of Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, MB, Canada
| | - Katie Galloway
- Department of Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, MB, Canada
| | - Kayla Reynolds
- Department of Cellular & Physiological Sciences, University of British Columbia, Vancouver, BC, Canada
| | - James T. Paul
- Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
- Department of Hematology and Medical Oncology, CancerCare Manitoba, Winnipeg, MB, Canada
| | - Craig Harlos
- Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
- Department of Hematology and Medical Oncology, CancerCare Manitoba, Winnipeg, MB, Canada
| | - Julian O. Kim
- Department of Radiology, University of Manitoba, Winnipeg, MB, Canada
- Department of Radiation Oncology, CancerCare Manitoba, Winnipeg, MB, Canada
| | - Shantanu Banerji
- Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
- Department of Hematology and Medical Oncology, CancerCare Manitoba, Winnipeg, MB, Canada
- CancerCare Manitoba Research Institute, CancerCare Manitoba, Winnipeg, MB, Canada
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Kandler C, Elsayad K, Evers G, Siats J, Kittel C, Scobioala S, Bleckmann A, Eich HT. Reduction of tumor volume during radiotherapy in patients with small-cell lung cancer and its prognostic significance. Strahlenther Onkol 2023; 199:1011-1017. [PMID: 37733039 PMCID: PMC10598169 DOI: 10.1007/s00066-023-02146-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 08/13/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND Several studies have reported the potential prognostic significance of tumor volume reduction ratio (VRR) induced by radiotherapy (RT) in patients with non-small-cell lung cancer. However, there are no data yet on the prognostic significance of volumetric shrinkage in patients with small-cell lung cancer (SCLC). This study aimed to demonstrate the correlation between tumor volume reduction ratio and treatment outcomes. MATERIALS AND METHODS The study included 61 patients with SCLC treated with fractionated RT of the primary tumor at our institution between 2013 and 2020. The relationship between volumetric changes in gross tumor volume (GTV) during radiotherapy and outcomes were analyzed and reported. RESULTS The median radiation dose was 59.4 Gy (median fraction dose was 1.8 Gy). The median GTV before radiotherapy was 74 cm3, with a median GTV reduction of 48%. There was a higher VRR in patients receiving concurrent radiochemotherapy (p = 0.05). No volumetric parameters were identified as relevant predictors of outcome in the entire cohort. In multivariate analysis, only age had an impact on survival, while prophylactic whole-brain radiation influenced the progression-free survival significantly. CONCLUSION Concurrent chemotherapy was associated with a higher VRR than sequential chemotherapy. No significant impact of VRR on patients' outcome or survival was detected.
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Affiliation(s)
- Christian Kandler
- Department of Radiation Oncology, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building A1, 48149, Muenster, Germany.
| | - Khaled Elsayad
- Department of Radiation Oncology, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building A1, 48149, Muenster, Germany
| | - Georg Evers
- Department of Medicine A (Hematology, Oncology, Hemostaseology and Pulmonology), University Hospital Muenster, Muenster, Germany
| | - Jan Siats
- Department of Radiation Oncology, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building A1, 48149, Muenster, Germany
| | - Christopher Kittel
- Department of Radiation Oncology, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building A1, 48149, Muenster, Germany
| | - Sergiu Scobioala
- Department of Radiation Oncology, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building A1, 48149, Muenster, Germany
| | - Annalen Bleckmann
- Department of Medicine A (Hematology, Oncology, Hemostaseology and Pulmonology), University Hospital Muenster, Muenster, Germany
| | - Hans Theodor Eich
- Department of Radiation Oncology, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building A1, 48149, Muenster, Germany
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