Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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The Prognostic Value of the Tumor Shrinkage Rate for Progression-Free Survival in Patients with Non-Small Cell Lung Cancer Receiving Gefitinib

  • Park, Dong Il (Division of Pulmonary, Department of Internal Medicine, Chungnam National University Hospital) ;
  • Kim, Sun Young (Division of Pulmonary, Department of Internal Medicine, Chungnam National University Hospital) ;
  • Kim, Ju Ock (Division of Pulmonary, Department of Internal Medicine, Chungnam National University Hospital) ;
  • Jung, Sung Soo (Division of Pulmonary, Department of Internal Medicine, Chungnam National University Hospital) ;
  • Park, Hee Sun (Division of Pulmonary, Department of Internal Medicine, Chungnam National University Hospital) ;
  • Moon, Jae Young (Division of Pulmonary, Department of Internal Medicine, Chungnam National University Hospital) ;
  • Chung, Chae Uk (Division of Pulmonary, Department of Internal Medicine, Chungnam National University Hospital) ;
  • Kim, Song Soo (Department of Radiology, Chungnam National University Hospital) ;
  • Seo, Jae Hee (Department of Preventive Medicine, Chungnam National University Hospital) ;
  • Lee, Jeong Eun (Division of Pulmonary, Department of Internal Medicine, Chungnam National University Hospital)
  • Received : 2015.04.14
  • Accepted : 2015.07.13
  • Published : 2015.10.30
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Abstract

Background: The efficacy of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) therapy can be measured based on the rate of treatment response, based on the Response Evaluation Criteria in Solid Tumors (RECIST) criteria or progression-free survival (PFS). However, there are some patients harboring sensitive EGFR mutations who responded poorly to EGFR-TKI therapy. In addition, there is variability in the PFS after EGFR-TKI treatment. Methods: We performed a retrospective analysis of the medical records of 85 patients with non-small cell lung cancer, who had achieved a stable disease or better response at the first evaluation of treatment response, after receiving a 2-month course of gefitinib. We calculated the tumor shrinkage rate (TSR) by measuring the longest and perpendicular diameter of the main mass on computed tomography before, and 2 months after, gefitinib therapy. Results: There was a significant positive correlation between the TSR and PFS (R=0.373, p=0.010). In addition, a simple linear regression analysis showed that the TSR might be an indicator for the PFS ($B{\pm}standard$ error, $244.54{\pm}66.79$; p=0.001). On univariate analysis, the sex, histologic type, smoking history and the number of prior chemotherapy regimens, were significant prognostic factors. On multivariate regression analysis, both the TSR (${\beta}$=0.257, p=0.029) and adenocarcinoma (${\beta}$=0.323, p=0.005) were independent prognostic factors for PFS. Conclusion: Our results showed that the TSR might be an early prognostic indicator for PFS in patients receiving EGFRTKI therapy.

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References

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  1. Tumor shrinkage rate as a potential marker for the prediction of long-term outcome in advanced non-small cell lung cancer treated with first-line tyrosine kinase inhibitors vol.15, pp.7, 2015, https://doi.org/10.4103/jcrt.jcrt_481_19