Skip to main content

Advertisement

SpringerLink
Log in

Neuron-specific enolase and response to initial therapy are important prognostic factors in patients with small cell lung cancer

  • Research Article
  • Published:
Clinical and Translational Oncology Aims and scope Submit manuscript

Abstract

Purpose

The prognostic factors for the survival of small cell lung cancer (SCLC) patients are still widely debated. The aim of this study was to identify the clinical features and prognostic factors in SCLC patients.

Methods

A retrospective study was conducted on SCLC patients who were treated in our hospital between July 2010 and July 2015. Comparison of overall survival (OS) was performed using the Kaplan–Meier method. Prognostic factors for OS were identified by multivariate Cox regression models.

Results

A total of 523 patients with complete data and ECOG 0-2 were enrolled in our study. A total of 383 patients (73.2%) were diagnosed with ES-SCLC (extensive-stage SCLC) and 140 patients (26.8%) were diagnosed with LS-SCLC (limited-stage SCLC). In all patients, early disease stage, good ECOG, normal neuron-specific enolase (NSE), thoracic radiotherapy, ≥4 cycles of chemotherapy, prophylactic cranial irradiation, good response to initial therapy were independent favorable prognostic factors for OS, along with gender, age, CEA and CA125. In LS-SCLC patients, normal NSE, normal CEA, good response to initial therapy and surgery were independent favorable prognostic factors for OS. In ES-SCLC patients, good ECOG, normal NSE, thoracic radiotherapy, ≥4 cycles of chemotherapy, prophylactic cranial irradiation and good response to initial therapy were independent favorable prognostic factors for OS. Remarkably, NSE and response to initial therapy were independent prognostic factors for OS in all SCLC patients, LS-SCLC patients and ES-SCLC patients.

Conclusion

The normal NSE and good response to initial therapy predicted a better survival for SCLC patients, regardless of disease stage.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Hann CL, Rudin CM. Management of small-cell lung cancer: incremental changes but hope for the future. Oncology. 2008;22(13):1486–92.

    PubMed  PubMed Central  Google Scholar 

  2. Yu JB, Decker RH, Detterbeck FC, Wilson LD. Surveillance epidemiology and end results evaluation of the role of surgery for stage I small cell lung cancer. J Thorac Oncol: Off Publ Int Assoc Study Lung Cancer. 2010;5(2):215–9. doi:10.1097/JTO.0b013e3181cd3208.

    Article  Google Scholar 

  3. Foster NR, Mandrekar SJ, Schild SE, Nelson GD, Rowland KM Jr, Deming RL, et al. Prognostic factors differ by tumor stage for small cell lung cancer: a pooled analysis of North Central cancer treatment group trials. Cancer. 2009;115(12):2721–31. doi:10.1002/cncr.24314.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Yip D, Harper PG. Predictive and prognostic factors in small cell lung cancer: current status. Lung Cancer. 2000;28(3):173–85.

    Article  CAS  PubMed  Google Scholar 

  5. Schneider BJ, Saxena A, Downey RJ. Surgery for early-stage small cell lung cancer. J Natl Compr Cancer Netw: JNCCN. 2011;9(10):1132–9.

    Article  PubMed  Google Scholar 

  6. Hong X, Xu Q, Yang Z, Wang M, Yang F, Gao Y, et al. The value of prognostic factors in Chinese patients with small cell lung cancer: a retrospective study of 999 patients. Clin Respir J. 2016;. doi:10.1111/crj.12534.

    Google Scholar 

  7. Micke P, Faldum A, Metz T, Beeh KM, Bittinger F, Hengstler JG, et al. Staging small cell lung cancer: veterans Administration Lung Study Group versus International Association for the Study of Lung Cancer—what limits limited disease? Lung Cancer. 2002;37(3):271–6.

    Article  PubMed  Google Scholar 

  8. Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 2009;45(2):228–47. doi:10.1016/j.ejca.2008.10.026.

    Article  CAS  PubMed  Google Scholar 

  9. Wu C, Li F, Jiao SC. Prognostic factors for survival of patients with extensive stage small cell lung cancer–a retrospective single institution analysis. Asian Pac J Cancer Prev: APJCP. 2012;13(10):4959–62.

    Article  PubMed  Google Scholar 

  10. Eskandar A, Ahmed A, Daughtey M, Kenderian S, Mahdi F, Khan A. Racial and sex differences in presentation and outcomes of small cell lung cancer in the United States: 1973 to 2010. Chest. 2015;147(4):e164–5. doi:10.1378/chest.14-3051.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Wheatley-Price P, Ma C, Ashcroft LF, Nankivell M, Stephens RJ, White SC, et al. The strength of female sex as a prognostic factor in small-cell lung cancer: a pooled analysis of chemotherapy trials from the Manchester Lung Group and Medical Research Council Clinical Trials Unit. Ann Oncol: Off J Eur Soc Med Oncol/ESMO. 2010;21(2):232–7. doi:10.1093/annonc/mdp300.

    Article  CAS  Google Scholar 

  12. Quon H, Shepherd FA, Payne DG, Coy P, Murray N, Feld R, et al. The influence of age on the delivery, tolerance, and efficacy of thoracic irradiation in the combined modality treatment of limited stage small cell lung cancer. Int J Radiat Oncol Biol Phys. 1999;43(1):39–45.

    Article  CAS  PubMed  Google Scholar 

  13. Yuen AR, Zou G, Turrisi AT, Sause W, Komaki R, Wagner H, et al. Similar outcome of elderly patients in intergroup trial 0096: cisplatin, etoposide, and thoracic radiotherapy administered once or twice daily in limited stage small cell lung carcinoma. Cancer. 2000;89(9):1953–60.

    Article  CAS  PubMed  Google Scholar 

  14. Isgro MA, Bottoni P, Scatena R. Neuron-specific enolase as a biomarker: biochemical and clinical aspects. Adv Exp Med Biol. 2015;867:125–43. doi:10.1007/978-94-017-7215-0_9.

    Article  CAS  PubMed  Google Scholar 

  15. Huang Z, Xu D, Zhang F, Ying Y, Song L. Pro-gastrin-releasing peptide and neuron-specific enolase: useful predictors of response to chemotherapy and survival in patients with small cell lung cancer. Clin Transl Oncol: Off Publ Fed Span Oncol Soc Natl Cancer Inst Mex. 2016;18(10):1019–25. doi:10.1007/s12094-015-1479-4.

    Article  CAS  Google Scholar 

  16. Petrovic M, Bukumiric Z, Zdravkovic V, Mitrovic S, Atkinson HD, Jurisic V. The prognostic significance of the circulating neuroendocrine markers chromogranin A, pro-gastrin-releasing peptide, and neuron-specific enolase in patients with small-cell lung cancer. Med Oncol. 2014;31(2):823. doi:10.1007/s12032-013-0823-1.

    Article  PubMed  Google Scholar 

  17. Buil-Bruna N, Lopez-Picazo JM, Moreno-Jimenez M, Martin-Algarra S, Ribba B, Troconiz IF. A population pharmacodynamic model for lactate dehydrogenase and neuron specific enolase to predict tumor progression in small cell lung cancer patients. The AAPS J. 2014;16(3):609–19. doi:10.1208/s12248-014-9600-0.

    Article  CAS  PubMed  Google Scholar 

  18. Maxwell P. Carcinoembryonic antigen: cell adhesion molecule and useful diagnostic marker. Br J Biomed Sci. 1999;56(3):209–14.

    CAS  PubMed  Google Scholar 

  19. Zhu H, Guo H, Li M, Zhang Y, Han A, Shi F, et al. Increased serum carcinoembryonic antigen level can predict poor survival of patients with small cell lung cancer. Transl Res: J Lab Clin Med. 2015;166(4):355–65. doi:10.1016/j.trsl.2015.04.005.

    Article  CAS  Google Scholar 

  20. Holdenrieder S, von Pawel J, Dankelmann E, Duell T, Faderl B, Markus A, et al. Nucleosomes, ProGRP, NSE, CYFRA 21-1, and CEA in monitoring first-line chemotherapy of small cell lung cancer. Clin Cancer Res: Off J Am Assoc for Cancer Res. 2008;14(23):7813–21. doi:10.1158/1078-0432.CCR-08-0678.

    Article  CAS  Google Scholar 

  21. Bast RC Jr, Badgwell D, Lu Z, Marquez R, Rosen D, Liu J, et al. New tumor markers: CA125 and beyond. Int J Gynecol Cancer: Off J Int Gynecol Cancer Soc. 2005;15(Suppl 3):274–81. doi:10.1111/j.1525-1438.2005.00441.x.

    Article  Google Scholar 

  22. Ando S, Suzuki M, Yamamoto N, Iida T, Kimura H. The prognostic value of both neuron-specific enolase (NSE) and Cyfra21-1 in small cell lung cancer. Anticancer Res. 2004;24(3b):1941–6.

    CAS  PubMed  Google Scholar 

  23. Simon G, Ginsberg RJ, Ruckdeschel JC. Small-cell lung cancer. Chest Surg Clin North Am. 2001;11(1):165–88, ix.

  24. Fried DB, Morris DE, Poole C, Rosenman JG, Halle JS, Detterbeck FC, et al. Systematic review evaluating the timing of thoracic radiation therapy in combined modality therapy for limited-stage small-cell lung cancer. J Clin Oncol: Off J Am Soc Clin Oncol. 2004;22(23):4837–45. doi:10.1200/JCO.2004.01.178.

    Article  Google Scholar 

  25. Slotman BJ, van Tinteren H, Praag JO, Knegjens JL, El Sharouni SY, Hatton M, et al. Use of thoracic radiotherapy for extensive stage small-cell lung cancer: a phase 3 randomised controlled trial. Lancet. 2015;385(9962):36–42. doi:10.1016/S0140-6736(14)61085-0.

    Article  PubMed  Google Scholar 

  26. Auperin A, Arriagada R, Pignon JP, Le Pechoux C, Gregor A, Stephens RJ, et al. Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission. Prophylactic Cranial Irradiation Overview Collaborative Group. N Engl J Med. 1999;341(7):476–84. doi:10.1056/NEJM199908123410703.

    Article  CAS  PubMed  Google Scholar 

  27. Slotman B, Faivre-Finn C, Kramer G, Rankin E, Snee M, Hatton M, et al. Prophylactic cranial irradiation in extensive small-cell lung cancer. N Engl J Med. 2007;357(7):664–72. doi:10.1056/NEJMoa071780.

    Article  CAS  PubMed  Google Scholar 

  28. Le Pechoux C, Dunant A, Senan S, Wolfson A, Quoix E, Faivre-Finn C, et al. Standard-dose versus higher-dose prophylactic cranial irradiation (PCI) in patients with limited-stage small-cell lung cancer in complete remission after chemotherapy and thoracic radiotherapy (PCI 99-01, EORTC 22003-08004, RTOG 0212, and IFCT 99-01): a randomised clinical trial. Lancet Oncol. 2009;10(5):467–74. doi:10.1016/S1470-2045(09)70101-9.

    Article  PubMed  Google Scholar 

  29. Rudin CM, Ismaila N, Hann CL, Malhotra N, Movsas B, Norris K, et al. Treatment of small-cell lung cancer: American Society of Clinical Oncology Endorsement of the American College of Chest Physicians Guideline. J Clin Oncol: Off J Am Soc Clin Oncol. 2015;33(34):4106–11. doi:10.1200/JCO.2015.63.7918.

    Article  CAS  Google Scholar 

  30. Manapov F, Niyazi M, Gerum S, Roengvoraphoj O, Eze C, Li M, et al. Evaluation of the role of remission status in a heterogeneous limited disease small-cell lung cancer patient cohort treated with definitive chemoradiotherapy. BMC Cancer. 2016;16:216. doi:10.1186/s12885-016-2245-x.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

This work was supported by grants from the Science and Technology Innovation Nursery Fund Project of PLA General Hospital (16KMM39).

Author information

Author notes

    Authors and Affiliations

    1. Department of Hematology and Oncology, The First Affiliated Hospital of the People’s Liberation Army General Hospital, 51 Fucheng Road, Beijing, 100048, People’s Republic of China

      M. Zhou, Z. Wang, Y. Yao, H. Zhou, M. Liu & J. Sun

    Authors
    1. M. Zhou
      View author publications

      You can also search for this author in PubMed Google Scholar

    2. Z. Wang
      View author publications

      You can also search for this author in PubMed Google Scholar

    3. Y. Yao
      View author publications

      You can also search for this author in PubMed Google Scholar

    4. H. Zhou
      View author publications

      You can also search for this author in PubMed Google Scholar

    5. M. Liu
      View author publications

      You can also search for this author in PubMed Google Scholar

    6. J. Sun
      View author publications

      You can also search for this author in PubMed Google Scholar

    Corresponding author

    Correspondence to J. Sun.

    Ethics declarations

    Conflict of interest

    The authors declare that they have no conflict of interest.

    Informed consent

    Informed consent was obtained from all individual participants included in the study.

    Research involving human participants and/or animals

    For this type of study formal consent is not required.

    Additional information

    M. Zhou, Z. Wang, and Y. Yao contributed equally to this work.

    Rights and permissions

    Reprints and permissions

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Zhou, M., Wang, Z., Yao, Y. et al. Neuron-specific enolase and response to initial therapy are important prognostic factors in patients with small cell lung cancer. Clin Transl Oncol 19, 865–873 (2017). https://doi.org/10.1007/s12094-017-1617-2

    Download citation

    • Received:

    • Accepted:

    • Published:

    • Issue Date:

    • DOI: https://doi.org/10.1007/s12094-017-1617-2

    Keywords

    Search

    Navigation