A nomogram for the prediction of the survival of patients with advanced non‐small cell lung cancer and interstitial lung disease

Author:

Xiu Weigang1,Zheng Jincheng2,Zhou Yuwen1,Du He3,Li Jiayu3,Li Wei3,Zhou Fei3ORCID,Zhou Caicun3ORCID,Wu Fengying3ORCID

Affiliation:

1. Department of Thoracic Oncology and State Key Laboratory of Biotherapy, Cancer Center, West China Hospital Sichuan University Chengdu 610041 PR China

2. Jinhua Municipal Central Hospital, Affiliated Jinhua Hospital Zhejiang University School of Medicine Zhejiang 321099 PR China

3. Department of Medical Oncology, Shanghai Pulmonary Hospital Tongji University School of Medicine Shanghai 200433 PR China

Abstract

AbstractBackgroundLung cancer is frequently accompanied by interstitial lung disease (ILD), and the overall survival (OS) of patients with these comorbidities is poor. Thus, we developed a nomogram for the prediction of the OS of patients with advanced non‐small cell lung cancer (NSCLC) and ILD.Patients and MethodsPatients with wild‐type gene advanced NSCLC with and without ILD who underwent chemotherapy between 2014 and 2019 were enrolled in the present study. The 0.5‐ and 1‐year progression‐free survival (PFS) and overall survival (OS) times of patients with and without ILD were determined using the Kaplan–Meier method. Cox regression was used to assess the prognostic value of clinical factors for patients with ILD. Based on the multivariate regression results, a nomogram for survival prediction was developed. The nomogram was validated using calibration curve.ResultsData from 155 patients with lung cancer and ILD and 118 matched patients with lung cancer alone who were receiving first‐line chemotherapy were analyzed. The first‐line chemotherapy regimens were paclitaxel + carboplatin, pemetrexed + carboplatin, gemcitabine + carboplatin, and other. The median PFS and OS were significantly shorter in patients with than in those without ILD (3.0 vs. 7.0 months [p < 0.001] and 7.0 vs. 15.0 months (p < 0.001), respectively). Multivariate analysis showed that the lymphocyte count (hazard ratio [HR] 2.38; 95% confidence interval [CI], 1.44–3.94; p = 0.01), partial pressure of oxygen (PaO2; HR, 1.37; 95% CI, 1.03–1.82; p = 0.03), and chemotherapy regimen were independently associated with prognosis. The nomogram showed good discriminatory ability [C‐index = 0.69 (95% CI, 0.49–0.82)]. Calibration curves showed that predicted and actual prognoses were consistent.ConclusionThis nomogram can aid the prediction of the OS of patients with advanced NSCLC and ILD.

Funder

National Natural Science Foundation of China

Publisher

Wiley

Subject

Cancer Research,Radiology, Nuclear Medicine and imaging,Oncology

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