Analysis Of Prognostic Factors And Establishment Of Prognostic Model For Small Cell Lung Cancer

Objectives: This study is aimed to retrospectively review the factors that may affect the survival of SCLC patients and to establish a predictive model(Nomogram)for predicting the survival of patients with small cell lung cancer,in order to individualized predict the survival of patients with small cell lung cancer,formulate accurate and effective treatment strategies.Methods: A total number of 451 patients who were diagnosed exactly as SCLC in The First Affiliated Hospital of China Medical University from January 2008 to May 2018 were enrolled in this study.The data was statistically analyzed by SPSS 22.0 software and Kaplan-Meier,Cox proportional hazards model were used in univariate and multivariate survival analysis respectively.According to the Cox regression coefficients,Nomogram was developed by R software.Thus,the survival of small cell lung cancer patients can be predicted intuitively and visually.Results: Univariate analysis found age ?NLR?hemoglobin?CRP?Alb?CRP/Alb ratio?serum sodium ? serum lactate dehydrogenase ? pre-treatment NSE levels ? chest radiotherapy?PCI?first-line chemotherapy efficacy and so on total 16 factors including liver metastasis?bone metastasis?brain metastasis and disease stage were closely related to OS.Further multivariate analysis revealed that hyponatremia and elevated pre-treatment NSE levels before treatment were independent risk factors for small cell lung cancer patients,chest radiotherapy? first-line chemotherapy efficacy reached CR or PR are independent protective factors;hemoglobin?CRP?Alb?CRP/Alb ratio?serum sodium?serum lactate dehydrogenase level?pre-treatment CEA levels?pre-treatment NSE levels?NSE variation tendency after 2 cycles of chemotherapy?chest radiotherapy?PCI?first-line chemotherapy?liver metastases?bone metastases?brain metastases?disease stage total 16 factors were closely related to PFS,further multivariate analysis found hyponatremia?elevated pre-treatment CEA level?elevated pre-treatment NSE level ?bone metastasis are independent prognostic risk factor for PFS in patients with small cell lung cancer,while chest radiotherapy?first-line chemotherapy efficacy reached CR or PR are independent protecting prognostic factors.Conclusions: hyponatremia?elevated pre-treatment NSE level?chest radioth-erapy?first-line chemotherapy efficacy are independent prognostic factors for OS,and hyponatremia?elevated pre-treatment CEA level?elevated pre-treatment NSE level?bone metastasis ? chest radiotherapy ? first-line chemotherapy efficacy are independent prognostic factors for PFS in patients with small cell lung cancer.