Chemotherapy-induced Myelosuppression Of Non-small Cell Lung Cancer: Clinical Analysis Of Risk Factors And Development Of A Predictive Model

Background Lung cancer is one of the malignant tumor what is the biggest threat to people health and life.Its incidence and mortality is growing fast.Nearly 50 years many countries have reported the incidence and mortality of lung cancer were significantly increased,lung cancer incidence and mortality rate in male are first of all malignant tumor,female's incidence is the second,mortality rate is the first.Chemotherapy is one of the main means of treatment of the lung cancer,and its major adverse reaction is bone marrow suppression.Bone marrow suppression not only can delay the treatment effect and impact of chemotherapy,but also can lead to complications and endanger the patient lives.Therefore,the accurate evaluation result in a risk factor for bone marrow suppression is one of the topics of clinical problems.Objective To analyze the risk factors of sever myelosuppression of non-small cell lung cancer and create a predictive model to judge the risk of sever myelosuppression.Method According to the WHO bone marrow suppression classification standard,we choose 80 patients with non-small cell lung cancer,the patients who reach the ?bone marrow suppression level and above as the experimental group,no bone marrow inhibition or bone marrow suppression only grade patients as? the control group.The risk factors associated with bone marrow suppression of the groups are managed by Chi-square test,The factors which had significance(P<0.05)were selected to be done by logistic regression analysis.According to the collection we develop a predictive model.According to the above grouping criteria,we select 50 patients with non-small cell lung cancer to verify this model.It Includes 17 cases who reach degr? ees and above of bone marrow suppression and 33 cases who has no bone marrow inhibition or bone marrow suppression is only? degrees.We inspect prediction model and the actual results by Kappa test.Result 1.Compared with the control group after chemotherapy,The difference of proportion of neutrophils and lymphocytes percentage has no statistical significance(P>0.05).Compared with the experimental group after chemotherapy,The difference of proportion of neutrophils and lymphocytes percentage has statistical significance(P<0.05).2.By Chi-square test,the factors that may lead to myelosuppression are Age>60 years old(P=0.037),BMI(P=0.037),the staging of tumor(P=0.036),Metastasis of bone marrow or bone(P=0.021),Low pertreatment white blood counts(white blood cell count <4.0×109/L)(P=0.001),Have received a number of radiotherapy(P=0.048),Have received the number of chemotherapy(P=0.023),Have received radiotherapy within 21 days(P=0.001)? 3.The factors that have statistical significance were selected to be done by unconditioned Logistic multifactor regression analysis.The important risk factors of chemotherapy-Induced myelosuppression are Age>60 years old(?=1.811,OR=6.117,P<0.05),Metastasis of bone marrow or bone(?=1.963,OR=7.118,P<0.05),Low pertreatment white blood counts(white blood cell counts<4.0×109/L)(?=3.368,OR=29.019,P<0.01),Have received radiotherapy within 21 days(?=2.961,OR=19.322,P<0.05).4.To assign the parameters,the age > 60 years old was 1.8,with bone marrow or bone metastasis was 2.0,Low pertreatment white blood counts(white blood cell count <4.0×109/L)was 3.4,Have received radiotherapy within 21 days was 3.0.We develop the model according to the regression coefficient.According to the above points we can divide the patients into low risk and high risk groups.The patients who score 5.1 points or less is the low-risk group,score > 5.1 points is the high-risk groups.5.To verify this model,the specificity of the prediction model is 97%,the sensitivity is 88.2%,the positive predictive value is 93.7%,the negative predictive value is 94.1%.The Kappa test shows the model and the actual test results are with a strong consistency(P < 0.05).Conclusion The predictive model test result is reliable.It can predictively judge the risk degree of bone marrow suppression in the patients with non-small cell lung cancer,we can guide clinical to give preventive treatment,in order to enhance and improve the patient's quality of life and prolong the survival period.