Park et al developed a model for predicting outcome for a patient with a nonsmall cell cancer of the lung treated with gefitinib as salvage therapy. These can help identify patients likely to benefit from the use of this drug. The authors are from Sungkyunkwan University in Seoul, Korea.
Patient selection: nonsmall cell lung cancer requiring salvage therapy, not ECOG 4
Parameters:
(1) ECOG performance scale
(2) intra-abdominal metastases
(3) serum alkaline phosphatase concentration
(4) time from diagnosis to gefitinib therapy in months
(5) serum albumin
(6) progression-free interval after previous chemotherapy
(7) white blood cell count
(8) smoking history
|
Parameter |
Finding |
Points |
|
ECOG performance scale |
0 or 1 |
0 |
|
|
2 or 3 |
1 |
|
intra-abdominal metastases |
absent |
0 |
|
|
present |
1 |
|
serum alkaline phosphatase |
normal |
0 |
|
|
elevated |
1 |
|
time from diagnosis to gefitinib |
=> 12 months |
0 |
|
|
< 12 months |
1 |
|
serum albumin |
>= 3.5 grams/dL |
0 |
|
|
< 3.5 g/dL |
1 |
|
progression free interval |
>= 12 weeks |
0 |
|
|
< 12 weeks |
1 |
|
white blood cell count |
<= 10,000 per µL |
0 |
|
|
>10,000 per µL |
1 |
|
smoking history |
never smoker |
0 |
|
|
ever smoker |
1 |
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 8
• The higher the score the worse the prognosis.
|
Total Score |
Risk Group |
Median Survival |
100% Mortality |
|
0 or 1 |
low, good |
18 months |
> 72 months |
|
2 or 3 |
intermediate |
12 months |
60 months |
|
4 or 5 |
poor |
4 months |
38 months |
|
6 to 8 |
very poor |
1.3 months |
11 months |
from Figure 2, page 1522
Specialty: Hematology Oncology, Surgery, general, Pulmonology
ICD-10: ,
