2339 - A Prospective Study on the Predictive Value of the Modified Glasgow Prognostic Score in Non-Small Cell Lung Cancer Treated with Radiation Therapy
Presenter(s)
Z. Chen1, K. Kuriyama2, M. Oguri3, M. Mutou1, K. Mitsuda1, S. Okabayashi1, M. Matsuda1, T. Akita1, J. Muramatsu1, K. Marino1, T. Komiyama1, and H. Onishi1; 1University of Yamanashi, Chuo, Japan, 2Yamanashi Prefectural Hospital, Kofu, Japan, 3Shizuoka General Hospital, Shizuoka, Japan
Purpose/Objective(s): To investigate the prognostic significance of the modified Glasgow Prognostic Score (mGPS) in predicting outcomes for patients with non-small cell lung cancer (NSCLC) treated with radiation therapy (RT) in a prospective setting.
Materials/Methods: This prospective observational study (UMIN000056183) included patients with histologically or clinically confirmed NSCLC, aged =18 years, and ECOG performance status 0–1. Written informed consent was obtained prior to enrollment. Pretreatment modified Glasgow Prognostic Score (mGPS) was calculated for all patients, with scores categorized as low (0) or high (1–2). Patients with stage I disease (UICC 8th edition) received stereotactic body radiation therapy (SBRT), while those with stage II or higher received concurrent chemoradiotherapy (CCRT) or RT alone. RT regimens were adapted to stage and tumor location. The primary endpoint was 2-year overall survival (OS), while secondary endpoints included 2-year local control rate (LCR), and distant failure-free rate (DFFR). Survival analysis was conducted using the Kaplan-Meier method, with group comparisons performed via the log-rank test. Multivariate analysis was conducted using the Cox proportional hazards model.
Results: Between January 2021 and December 2023, 92 patients were enrolled; 82 were included in the final analysis following exclusion of 4 patients who withdrew and 6 with incomplete data. The median age was 78 years, and 89% had stage < II disease. SBRT was delivered in 70% of cases. The 2-year OS, LCR and DFFR were 85.4%, 86.5%, and 80.1%, respectively. A high mGPS was significantly associated with worse OS (hazard ratio 5.75; 95% confidence interval: 1.97–16.79; P = 0.001), but no significant associations were observed with LCR or DFFR. Median survival for patients with a high mGPS was 36.2 months, whereas it was not reached for those with a low mGPS. Among the SBRT subgroup (n = 57), mGPS remained a significant predictor of OS (P = 0.007) but showed no significant correlation with LCR or DFFR.
Conclusion: This prospective study provides robust evidence supporting the long-term prognostic value of the mGPS in NSCLC patients undergoing RT, establishing it as an independent predictor of OS and supporting its clinical utility for outcome assessment.