Early osteosclerotic changes predict chemotherapy response in non-small-cell lung cancer patients with bone metastases.

OBJECTIVES

To explore the relationship between osteosclerotic changes and chemotherapy response in non-small-cell lung cancer (NSCLC) patients with bone metastases (BM).

METHODS

Fifty-two NSCLC patients with BM were enrolled from 1 January 2010-31 June 2015 and divided into two groups based on their CT features: an osteosclerotic change (OC) group and a no-osteosclerotic change (NOC) group. The disease control rate (DCR) was evaluated, and progression-free survival (PFS) was analysed using Kaplan-Meier curves. Univariate and multivariate Cox regression analyses were performed to analyse the factors that could affect PFS.

RESULTS

Osteosclerotic changes were observed in 35/52 patients. The median interval when osteosclerotic changes occurred was 2 months (range 1-3 months) after chemotherapy. The OC group had a significantly higher 3-month DCR than the NOC group (p < 0.001). The OC group had a higher 1-year PFS rate than the NOC group (1-year PFS: 74.9% vs. 30.2%, p < 0.001). Univariate Cox regression analysis indicated that pathological subtype (HR = 4.419; 95% CI = 1.635-11.941, p = 0.003) and osteosclerotic changes (HR = 0.199; 95% CI = 0.083-0.477, p < 0.001) were significant predictors of PFS.

CONCLUSION

Early osteosclerotic changes predict chemotherapy response in NSCLC patients with BM.

KEY POINTS: • Osteosclerotic changes were prevalent CT features after chemotherapy in NSCLC patients. • Osteosclerotic changes were positively related to increased 3-month DCR. • Osteosclerotic changes were positively related to increased 1-year PFS rate.