Ufuk YILMAZ, Gülru POLAT, Zekiye Aydoğdu DİNÇ, Berna KÖMÜRCÜOĞLU

SİSPLATİN-BAZLI KEMOTERAPİ İLE TEDAVİ EDİLEN İLERİ EVRE AKCİĞER KANSERİNDE ERCC1 EKSPRESYON DÜZEYİ İLE TEDAVİYE YANIT VE YAŞAM SÜRESİ ARASINDA İLİŞKİ VAR MIDIR?

Küçük hücreli dışı akciğer kanserinin (KHDAK) tedavisinde, sisplatine karşı tümör direncinin önceden tahmin edilebilmesi önemlidir. Bu çalışmanın amacı, sisplatin içeren kemoterapi rejimi ile tedavi edilen KHDAK li hastalarda, immünhistokimyasal olarak ölçülen tümör ERCC1 sunum düzeylerinin, tedaviye yanıt ve yaşam süresini tahmin etmedeki yerini araştırmaktır. KHDAK tanısı ile, sisplatin ve vinorelbin ya da dosetaksel ilk sıra kemoterapisi alan 119 hasta arasından, yeterli tümör dokusuna sahip olduğu saptanan 39 (%32) hastanın tümör örnekleri, imünohistokimyasal olarak ERCC1 ekspresyonu yönünden analiz edildi. ERCC1 sunumu skor 0-1 olanlar ERCC1 sunum negatif, skor 2-3 olanlar ERCC1 sunum pozitif grup olarak değerlendirildi. ERCC1 pozitif ve negatif grup arasında kemoterapiye yanıt yönünden fark saptanmadı (p=0.63). Ortalama yaşam süresi ERCC1 negatif grupta 14.7 ay (%95 GA; 10.0-19.3 ay), ERCC1 pozitif grupta 10.9 ay (%95 GA; 7.4-14.3 ay) olarak saptandı (P=0.23), progresyonsuz yaşam süresi ise ERCC1 negatif grupta 7.9 ay (%95 GA: 5.8-9.9 ay), ERCC1 pozitif grupta 6.2 ay (%95 GA; 4.0-8.5 ay) olarak saptandı (P=0.27). Sonuç olarak, çalışma grubumuzu oluşturan KHDAK'li hastaların, tedavi öncesi tümör örneklerinde imünohistokimyasal olarak ERCC1 ekspresyon düzeyinin tespiti, sisplatin bazlı kemoterapiye yanıtı ve prognozu tahmin etmede yararlı olmamıştır.

Anahtar Kelimeler:

Sisplatin, metastatik, akciğer kanseri, tedavi, ERCC1

IS THERE RELATIONSHIP BETWEEN ERCC1 EXPRESSION LEVEL AND RESPONSE TO TREATMENT AND PROGNOSIS IN ADVANCED STAGE LUNG CANCER TREATED WITH CISPLATIN-BASED CHEMOTHERAPY?

It is important to know the tumor resistance against cisplatin before the treatment of nonsmall cell lung cancer (NSCLC). The purpose of this study was to evaluate the response to treatment and survival in patients with NSCLC treated with cisplatin-based chemotherapy according to ERCC1 Expression. Among 119 patients treated with cisplatin and vinorelbine or docetaxel, 39 (32%) patients enrolled who have enough tumor tissue to analyse ERCC1 expression. ERCC1 expression defined as negative in score 0-1, positive in score 2-3. There was no difference between ERCC1 positive and negative groups (p:0.63). Mean survival was 14.7 month (95% CI; 10.0-19.3 month) in ERCC1 negative group , 10.9 month (95% CI; 7.4-14.3 month) in ERCC1 positive group(p:0.23). Progression free survival was 7.9 month in ERCC1 negative group (95% CI;5.8-9.9 month), 6.2 month in ERCC1 positive group (95% CI;4.0- 8.5 month)(p:0.27). In conclusion; to identify ERCC1 expression level of tumor tissues in NSCLC patients before treatment was not usefull in prediction of treatment response and prognosis.

Keywords:

Sisplatin, metastatik, akciğer kanseri, tedavi, ERCC1,

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Dr. Suat Seren Göğüs Hastalıkları ve Göğüs Cerrahisi Eğitim ve Arafltırma Hastanesi, Göğüs Hastalıkları, İZMİR e-posta : gulruerbay@yahoo.com