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The nutritional status of patients with small cell lung cancer before and during treatment with chemotherapy
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175 THE NUTRITIONllL STRTUS OF PRTIENTSYITH SHALL CELL LUN6 CANCER BEFORE AN0 DURING TRERTNENTUITH CHENOTHERRPY
THE PROGNOSTICVALUE OF BONOCYTEFUNCTION IN PATIENTSUITH WALL CELL LUNG CRNCER (SCLCl H S R HOSKERt P ilcAROLEt P d CORRISX Departmentsof RespiratoryBedicinettland Haenatology(+l, Freeman Hospital,Newcastleupon Tyne NE7 70N England,
H S R HOSKER G h JONES P R CORRIS Departacntof RespiratoryMedicine,FreenanHospital, Newcastleupon Tyne NE7 70N England,
A cheniluninescence (CL1 assay was used to assess blood aonocyte functionin 25 patientswith small cell lung cancer (SCLClat diagnosisand 20 controlsubjects,Lucigeninwas used as the probe and latex beads as the stiaulus,Assays were repeated6 weeks later in 22 patientswith SCLC, prior to the third pulse of chemotherapy(CT). Nine patientswere studied in remissionand IO patientswere studied at relapse, CL responsesin the SCLC group at diagnosiswere slightly higher than controls,The 7 patientswith extensivestage SCLC had depressedresponsescomparedto 18 patientswith limiteddisease (p
The nutritionalstatus of patientswith SCLC was assessed before (N=351and 6 weeks after 0(*281 treatmentwith chemotherapy, and was comparedwith age-matchedcontrolsiN=301and patientswith severe chronicobstructiveairwaysdisease tCOABltN=l71, Patientswith SCLC had lower mean body mass index (BBIl, total lymphocytecount and skin fold thicknessmeasurerentscomparedto controls,Patientswith CORD had more marked changeswith BBI, total lymphocytecounts and skinfoldthicknesseslower than both control and SCLC groups,Total protein,albumin and transferrin levelsdid not discriminatebetween the three groups,Creatinineheight index and delayed hypersensitivity skin testingwere too variableto be of use, Rest indicesof nutritiontended to fall six weeks after treatment,althoughskinfoldthicknesseswere unaltered,Changes in total lymphocytecounts were most marked,probablydue to a direct effect of chemotherapy, Patients in remissionhad total lyaphocyte countsand skinfoldthicknessesbelow those of controls, Total lymphocytecount at diagnosiscorrelatedwith survival time (r=.46;p
176
177 THE PROGNOSTICSIGNIFICANCEOF 3 TUftOUR HARKERS (NSE, TPP, SbCEl IN PATIENTSUITH SBRLL CELL LUNG CANCER
H S R HOSKER J DAY G B JONES I TARBITT P P CORRIS Departmentsof RespiratoryMedicineand Biochemistry, FreemanHospital,Newcastleupon Tyne NE7 7DN England, Non-specificenolase (NSEl,Tissue polypeptideantigen (TPA) and Rngiotensinconvertingenzyme (WE1 are tunourmarkers for bronchialcarcinoma,but only NSE has been shown to be of prognosticsignificancein SCLC, 11113 tunour markerswere measured seriallv in 23 patientswith SCLC treatedwith chemotherapy(CT), Tuaour earke; levelsat diagnosiswere slightlyhigher in patientswith extensivedisease (N=71,NSE and TPA levels reflected the course of disease,falling6 weeks after the start of CT, and fallingfurther in renission,Levels rose dramaticallyat relapse, Pre-treatmentlevelsof both NSE and TPR showed an inverse correlationwith survivaltime (NSE: p
Ldernlned ProgaoaticPaetora? Tke possible lole of InitialTuor Sire(ITS1andClinical Severity Staging(CSSlin StageIIIIKLC. Karstens,J.H.,D. Andreopoulos, J. AlronDept.of Radiotherapy, Technical University of Aachen, Germany Althoughlocal controlin generalis dependenton ITS and syaptoas likepreceding pneuaonia possibly havea negative iapact are not on survivalin Stage III NSCLC,ITS andCSS currently consideredas relevant prognosticfactors.Cosparisonof treataentresult9 aay be aisleading if onlyconventional factors are considered. In our retrospective study 22 pts uith Stage III
NSCLCiIIIA=B ; IIIS=lll bad been treated with irradiation and concurrent cieplatin and vindesine (BCOG 51; weight loss tll%l. WeanTine to Local Progression [TLP]uas 11,1 months 111 , lledian Survival Time [HST]16,6 I and 3 year [yr] survival la\. Based on uaxioun tuxor diameter as measured by CT2 groups Ill pts each) 8ere forced: ITS (6 co (II and 26 CI (III.TLP is 20,lIIIvs A,5 (III a lp=O,OOl Log Bankl,WST 22,s (11VB 11,5 III) I ip=D.O32 Log Rank1and 3 yr survival 36\ (II vs 04 (III. CSSwas assessed according to A.R. Peinstein Medicine 69:f-33 ,19901. 2 pts were A (asynptoratic I past episode of pulmonary symptoms[syll, 14 uere S (pulxonic sy ! systeaic sy) and 6 were C (regional ! nediastinal xetastatic sy f major weight 1039l, none had D (distant metastatic syl or g (prognostic colorbitityl. Based on Peinstein’s suvival data as a control group, WSTuas prolonged by factor 2 by radiochecotherapy. He conclude tbat ITS probably is an ixportant prognostic factor: regarding CSS, Feinstein’s approach should be evaluated in future studies, as performance status does not include cliuical symptoms.
175 THE NUTRITIONllL STRTUS OF PRTIENTSYITH SHALL CELL LUN6 CANCER BEFORE AN0 DURING TRERTNENTUITH CHENOTHERRPY
THE PROGNOSTICVALUE OF BONOCYTEFUNCTION IN PATIENTSUITH WALL CELL LUNG CRNCER (SCLCl H S R HOSKERt P ilcAROLEt P d CORRISX Departmentsof RespiratoryBedicinettland Haenatology(+l, Freeman Hospital,Newcastleupon Tyne NE7 70N England,
H S R HOSKER G h JONES P R CORRIS Departacntof RespiratoryMedicine,FreenanHospital, Newcastleupon Tyne NE7 70N England,
A cheniluninescence (CL1 assay was used to assess blood aonocyte functionin 25 patientswith small cell lung cancer (SCLClat diagnosisand 20 controlsubjects,Lucigeninwas used as the probe and latex beads as the stiaulus,Assays were repeated6 weeks later in 22 patientswith SCLC, prior to the third pulse of chemotherapy(CT). Nine patientswere studied in remissionand IO patientswere studied at relapse, CL responsesin the SCLC group at diagnosiswere slightly higher than controls,The 7 patientswith extensivestage SCLC had depressedresponsescomparedto 18 patientswith limiteddisease (p
The nutritionalstatus of patientswith SCLC was assessed before (N=351and 6 weeks after 0(*281 treatmentwith chemotherapy, and was comparedwith age-matchedcontrolsiN=301and patientswith severe chronicobstructiveairwaysdisease tCOABltN=l71, Patientswith SCLC had lower mean body mass index (BBIl, total lymphocytecount and skin fold thicknessmeasurerentscomparedto controls,Patientswith CORD had more marked changeswith BBI, total lymphocytecounts and skinfoldthicknesseslower than both control and SCLC groups,Total protein,albumin and transferrin levelsdid not discriminatebetween the three groups,Creatinineheight index and delayed hypersensitivity skin testingwere too variableto be of use, Rest indicesof nutritiontended to fall six weeks after treatment,althoughskinfoldthicknesseswere unaltered,Changes in total lymphocytecounts were most marked,probablydue to a direct effect of chemotherapy, Patients in remissionhad total lyaphocyte countsand skinfoldthicknessesbelow those of controls, Total lymphocytecount at diagnosiscorrelatedwith survival time (r=.46;p
176
177 THE PROGNOSTICSIGNIFICANCEOF 3 TUftOUR HARKERS (NSE, TPP, SbCEl IN PATIENTSUITH SBRLL CELL LUNG CANCER
H S R HOSKER J DAY G B JONES I TARBITT P P CORRIS Departmentsof RespiratoryMedicineand Biochemistry, FreemanHospital,Newcastleupon Tyne NE7 7DN England, Non-specificenolase (NSEl,Tissue polypeptideantigen (TPA) and Rngiotensinconvertingenzyme (WE1 are tunourmarkers for bronchialcarcinoma,but only NSE has been shown to be of prognosticsignificancein SCLC, 11113 tunour markerswere measured seriallv in 23 patientswith SCLC treatedwith chemotherapy(CT), Tuaour earke; levelsat diagnosiswere slightlyhigher in patientswith extensivedisease (N=71,NSE and TPA levels reflected the course of disease,falling6 weeks after the start of CT, and fallingfurther in renission,Levels rose dramaticallyat relapse, Pre-treatmentlevelsof both NSE and TPR showed an inverse correlationwith survivaltime (NSE: p
Ldernlned ProgaoaticPaetora? Tke possible lole of InitialTuor Sire(ITS1andClinical Severity Staging(CSSlin StageIIIIKLC. Karstens,J.H.,D. Andreopoulos, J. AlronDept.of Radiotherapy, Technical University of Aachen, Germany Althoughlocal controlin generalis dependenton ITS and syaptoas likepreceding pneuaonia possibly havea negative iapact are not on survivalin Stage III NSCLC,ITS andCSS currently consideredas relevant prognosticfactors.Cosparisonof treataentresult9 aay be aisleading if onlyconventional factors are considered. In our retrospective study 22 pts uith Stage III
NSCLCiIIIA=B ; IIIS=lll bad been treated with irradiation and concurrent cieplatin and vindesine (BCOG 51; weight loss tll%l. WeanTine to Local Progression [TLP]uas 11,1 months 111 , lledian Survival Time [HST]16,6 I and 3 year [yr] survival la\. Based on uaxioun tuxor diameter as measured by CT2 groups Ill pts each) 8ere forced: ITS (6 co (II and 26 CI (III.TLP is 20,lIIIvs A,5 (III a lp=O,OOl Log Bankl,WST 22,s (11VB 11,5 III) I ip=D.O32 Log Rank1and 3 yr survival 36\ (II vs 04 (III. CSSwas assessed according to A.R. Peinstein Medicine 69:f-33 ,19901. 2 pts were A (asynptoratic I past episode of pulmonary symptoms[syll, 14 uere S (pulxonic sy ! systeaic sy) and 6 were C (regional ! nediastinal xetastatic sy f major weight 1039l, none had D (distant metastatic syl or g (prognostic colorbitityl. Based on Peinstein’s suvival data as a control group, WSTuas prolonged by factor 2 by radiochecotherapy. He conclude tbat ITS probably is an ixportant prognostic factor: regarding CSS, Feinstein’s approach should be evaluated in future studies, as performance status does not include cliuical symptoms.