An investigation of the determinates of survival in patients with inoperable non-small cell lung cancer: The role of the systemic inflammatory response

Forrest, Lynn M (2004) An investigation of the determinates of survival in patients with inoperable non-small cell lung cancer: The role of the systemic inflammatory response. MSc(R) thesis, University of Glasgow.

Abstract

Lung cancer is the commonest cause of cancer related death in North America and Western Europe. It comprises of two subgroups, small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). Non-small cell lung cancer accounts for approximately three quarters of all patients presenting with lung cancer. The majority of patients present with advanced disease, survival is extremely poor with a median survival rate of 6 to 9 months. Many patients are unfit for radical treatments such as surgery / radiotherapy, and therefore receive palliative treatment only. Traditionally, selection of these patients for active or supportive treatment has been based on clinico-pathological criteria, including age, stage, performance status, weight loss or hypoalbuminaemia. Palliation of symptoms, improvement in patient's quality of life and prolongation of survival are the main aims of treatment. Various factors have been associated with the poor survival rates of patients with inoperable non-small cell lung cancer. These include stage of disease, performance status and loss of weight. In these patients, weight loss has been reported to be associated with either reduced energy intake or increased energy expenditure, or as a combination of both. The resultant negative energy balance leads to a loss of adipose tissue and protein mass, resulting in tissue wasting, reduced performance status and ultimately death. The reasons for the negative energy balance remain unclear. However, previous studies of advanced cancer have reported that various factors contribute to an increased resting energy expenditure including the presence of a systemic inflammatory response, as evidenced by raised circulating concentrations of C-reactive protein. Therefore it may be that the presence of the systemic inflammatory response may be associated with poor survival. The primary aim of this thesis was to assess the impact of the systemic inflammatory response on survival in patients with inoperable non-small cell lung cancer. In addition, an inflammation based prognostic score was constructed and evaluated. The results of this study demonstrated that the components of the GPS were more sensitive indicators of disease progression than the GPS itself. This suggests that the GPS may require more refinement in order to improve the monitoring of disease progression in patents with inoperable NSCLC. In conclusion, the work presented in this thesis suggests that the Glasgow Prognostic score may be useful in the assessment of patients with inoperable non-small cell lung cancer. Further work should be carried out to assess its value in other advanced cancers. (Abstract shortened by ProQuest.).

• Item Type: Thesis (MSc(R))
• Qualification Level: Masters
• Additional Information: Adviser: Donald C McMillan
• Keywords: Oncology
• Date of Award: 2004
• Depositing User: Enlighten Team
• Unique ID: glathesis:2004-74252
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 23 Sep 2019 15:33
• Last Modified: 23 Sep 2019 15:33
• URI: https://theses.gla.ac.uk/id/eprint/74252