Palliative chemotherapy (CT) for advanced non-small cell lung cancer (NSCLC): Investigating disparities between patients who are treated versus those who are not.
Notice bibliographique
Résumé
e17681 Background: Palliative CT in advanced NSCLC is associated with improved overall survival (OS) and quality of life, yet many patients remain untreated. In this study, we explored the differences between patients who did not receive palliative CT versus those who did, with a goal of better understanding and supporting the untreated. Methods: We performed a retrospective analysis of all newly diagnosed patients with advanced NSCLC seen at our institution between 2009 and 2012. Demographics, treatment, and survival data were collected. Fisher’s exact test assessed the association between CT use and baseline characteristics. Multivariate analysis of OS was performed using Cox regression models. Results: In total, 528 patients were seen: 291 (55%) received ≥ 1 line palliative CT, while 237 (45%) received none. Demographics were as follows: Median age 67, 55% male, 50% ECOG performance status (PS) 0-1, 48% with > 5% weight loss. Untreated patients were older (median 71 v 64, p < 0.01) and less fit (ECOG 0-1 in 27% v 69%, p < 0.01). More had weight loss (57% v 41%, p < 0.01), anemia (7% v 4%, p = 0.01), thrombocytosis (28% v 23%, p < 0.01), leukocytosis (38% v 32%, p < 0.01), and renal impairment (10% v 5%, p < 0.01). Reasons for no treatment included poor performance status (67%) and patient choice (23%). Median OS was shorter among untreated patients (3.9 v 10.7 months, HR 1.80 [95% CI 1.4-2.3], p < 0.01). In multivariate analysis, in addition to not receiving systemic therapy, factors associated with shorter OS were age, PS, weight loss, leukocytosis and thrombocytosis. Conclusions: Unsurprisingly, patients who did not receive CT had more poor prognostic features and worse OS. However, it is of concern that despite being seen in an active academic center, nearly half of all patients with advanced NSCLC received no anti-cancer treatment, most commonly due to poor PS. Current research primarily seeks to improve outcomes amongst those receiving systemic therapy, but this suggests that the lung cancer community must urgently advocate for the untreated. This should include more rapid diagnosis prior to functional decline, and development of therapies effective in a sicker population.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,010 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».