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Prognostic Value of SPARC Expression in Unresectable NSCLC Treated with Concurrent Chemoradiotherapy

  • Kurtul, Neslihan (Department of Radiation Oncology, Sutcu Imam University Medical Faculty) ;
  • Eroglu, Celalettin (Department of Radiation Oncology, Erciyes University Medical Faculty) ;
  • Unal, Dilek (Department of Radiation Oncology, Kayseri Education and Research Hospital) ;
  • Tasdemir, Erdem Arzu (Department of Pathology, Kayseri Education and Research Hospital) ;
  • Orhan, Okan (Department of Radiation Oncology, Erciyes University Medical Faculty) ;
  • Zararsiz, Gokmen (Department of Biostatistics and Medical Informatics, Erciyes University Medical Faculty) ;
  • Baran, Munevver (Department of Pathology, Erciyes University Medical Faculty) ;
  • Kaplan, Bunyamin (Department of Radiation Oncology, Erciyes University Medical Faculty) ;
  • Kontas, Olgun (Department of Pathology, Erciyes University Medical Faculty)
  • Published : 2014.11.06

Abstract

Background: The aim of the present study was to determine the predictive/prognostic value of the secreted protein, acidic and rich in cysteine (SPARC) in cases of unresectable, locally advanced, non-small cell lung cancer. Materials and Methods: The study included 84 patients with Stage IIIA-B non-small cell lung cancer, undergoing simultaneous chemoradiotherapy including radiotherapy at a dose of 66 Gy and weekly docataxel ($20mg/m^2$) and cisplatin ($20mg/m^2$). SPARC expression was studied in biopsy material by immunohistochemical methods and correlations with treatment responses or survival were evaluated. Results: Median overall survival was $16{\pm}2.73$ (11.55-20.46) months for low expression vs $7{\pm}1.79$ months (7.92-16.08) months for high expression (p=0.039), while median local control was $13{\pm}2.31$ (8.48-17.5) months for low expression vs $6{\pm}0.85$ (4.34-7.66) months for high expression (p=0.045) and median progression-free survival was $10{\pm}2.31$ (5.48-14.5) months for low expression vs $6{\pm}1.10$ (3.85-8.15) months for high expression (p=0.022). In both univariate and multivariate analyses, high SPARC expression was associated with significantly shorter overall survival (p=0.003, p=0.007, respectively), local control (p=0.008, p=0.036) and progression-free survival (p=0.004, p=0.029) when compared to low SPARC expression. No significant difference was detected between high and low SPARC expression groups regarding age, sex, T stage, N stage, histopathology and stage-related patient characteristics. Conclusions: High SPARC expression was identified as a poor prognostic factor in cases with locally advanced NSCLC treated with concurrent chemoradiotherapy.

Keywords

NSCLC;SPARC expression;prognosis;chemoradiotherapy

Acknowledgement

Supported by : Erciyes University

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