Clinical outcome for small cell lung cancer patients with bone metastases at the time of diagnosis

Objectives: The characteristics and prognostic factors of small-cell lung cancer (SCLC) patients with bone metastases at first diagnosis have scarcely been reported. This study aimed to analyze the prognostic factors of these patients and to develop a scoring system for survival to provide evidence for clinical treatment decisions.

Materials and methods: The records of 102 SCLC patients with bone metastasis at the time of diagnosis who were seen in our hospital between May 2010 and May 2015 were retrospectively reviewed. The log-rank test and multivariate Cox regression analysis were used to evaluate potential clinical predictors of survival. A scoring system was developed based on the hazard ratios of significant independent prognostic factors.

Result: The most common site of bone metastases was the spine (64.7%), and 26 patients (25.6%) had a single bone metastasis. The median survival was 10.4 months, and the 2-year survival rate was 10.3%. Age, number of bone metastases, and occurrence of extraosseous distant metastases were significant independent prognostic factors for overall survival. Based on their scores, patients were divided into three groups. The median survival times of the three groups were 6.4 months, 8.5 months and 12.4 months, and the 2-year survival rates were 0%, 2.9%, and 19.3% (p=0.000). Twenty-six patients (25.5%) developed skeletal-related events (SREs), and the most common SREs were radiation to the bone (22.5%) and spinal cord compression (11.8%).

Conclusion: This study includes preliminary clinical data of SCLC patients with bone metastases at the time of diagnosis, and more studies are needed.