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RESULT

A total of 137 patients who suffered from inoperable lung cancer were screened and 9 patients is lost to follow up. Among the rest, patients was divided into two group of treatment ; standard teratment and test treatment and were follow up for a period of 3 years or until death. Out of these, for each treatment, 64 patiens received a standard treatment and test treatment. Baseline characteristics of the two groups are shown in Table 1.

Treatment

StandardTreatment 1 (n=64)

TestTreatment 2 (n=64)

Celltype1- Squamous 13 (41.9%) 18 (58.1%)2- Smallcell 28 (62.1%) 17 (37.9%)3- Adeno 9 (34.6%) 17 (65.4%)4- Large 14 (53.9%) 12 (46.3%)

Age in Years 57 ± 11 (54-60) 60 ± 10 (57-62)Month from Diagnosis 8.9 ± 9.0 (6.9-11.1) 8.9 ± 12.5 (5.7-12.0)Prior Therapy

Yes = 10 20 (54.1%) 17 (45.9%)No = 0 44 (48.4%) 47 (51.6%)

Karnofsky Score 58.20 ± 18.68 56.88 ± 21.17

Table 1 : Characteristic of Patients

From Table 1, the patients with Squamous celltype was 13 patients (41.9%) and 18 patients (58.1%) for standard and test treatment respectively. For the Smallcell celltype, there was about 28 patients (62.1%) for standard treatment and 17 patients (37.9%) for test treatment. Meanwhile, for patients with Adeno celltype, there was 9 and 17 patients for standard and test treatment respectively. From the Large celltype, there was 14 patients and 12 patients for standard and test treatment respectively.

The mean (±SD) age for standard treatment is 57 years (range, 55-60), whereas for test treatment is 60 years (range, 57-62). The standard and test treatment was conducted from an average 8.9 months from the diagnosis with (range, 6.9-11.1). and (range, 5.7-12.0), respectively. Among the patients, 20 patients for standard treatment and 17 patients for test treatment has a prior therapy history.

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Survival in Days

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Mean 132.777Median 80IQR 137

Table of Statistics

Survival Plot for Survival in Days

Censoring Column in StatusKaplan-Meier Method

Figure 1 : Kaplan-Meier for both treatments

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Survival in Days

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123.928 103 135

142.061 52 116

Mean Median IQRTable of Statistics

12

Treatment

Survival Plot for Survival in Days


Figure 2 : Kaplan Meier survival analysis by treatment groups

From Figure 1, overall median survival when both groups were taken together was 80 days. Figure 2 shows the Kaplan-Meier survival curve of all patients. Median survival in the standard treatment group was 103 days and in test treatment group, it was 52 days. The difference was not statistically significant (p=0.928>0.05, log rank test).

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Survival in Days

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136.790 110 10294.793 52 11972.889 92 105

200.522 177 145


1234

Celltype

Survival Plot for Survival in Days (T1)


Figure 3 : Kaplan Meier survival analysis with different celltype according to standard treatment (T1)

For the standard treatment group, the median survival for patients with Squamous celltype (C1), Smallcell (C2), Adeno (C3) and Large (C4) was 110 days, 52 days, 92 days and 177 days respectively (Figure 3). Survival difference between the the celltypes was statistically significant (p=0.022<0.05, log rank test). From the figure 3 above, 8.3% patients with Squamous celltype survived more than 300 days. 13.0% patients with Smallcell survived more than 150 days. 55.6% of patients with Adeno celltype survived more than 35 days and 7.8% patients for Large celltype survived more than 278 days.

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Survival in Days

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293.362 201 35947.167 25 6762.056 48 60

132.333 53 121


1234

Celltype

Survival Plot for Survival in Days (T2)


Figure 4 : Kaplan Meier survival analysis with different celltype according to test treatment (T2)

For the test treatment group, the median survival for patients with Squamous celltype (C1), Smallcell (C2), Adeno (C3) and Large (C4) was 201 days, 25 days, 48 days and 53 days respectively (Figure 4). Survival difference between the the celltypes was statistically significant (p=0.000<0.05, log rank test). From the Figure 4 above, 12.2% patients with Squamous celltype

survived more than 500 days. 5.6% patients with Smallcell survived more than 99 days. 13.9% of patients with Adeno celltype survived more than 90 days and 16.7% patients for Large celltype survived more than 200 days.

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Survival in Days 1

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ent 133.000 100 198

104.211 72 124


<60≥60

YearsAge in

Survival Plot for Survival in Days T1

Censoring Column in Status 1Kaplan-Meier Method

Figure 5 : Kaplan Meier survival analysis for Age according to standard treatment (T1) (p=0.459)

Figure 5 shows that, the median survival time for standard treatment (T1) patients with age less than 60 years is 100 days. Meanwhile the median survival time for patients with age more than or equal to 60 years is 72 days. Survival difference between the age was statistically not significant (p=0.459>0.05, log rank test).

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Survival in Days 2

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ent 185.381 49 182

100.488 61 87


<60≥60

YearsAge in



Figure 6 : Kaplan Meier survival analysis for Age according to test treatment (T2) (p=0.435)

Meawhile for test treatment, Figure 6 shows that, the median survival time for patients with age less than 60 years is 49 days. Meanwhile the median survival time for patients with age more than or equal to 60 years is 61 days. Survival difference between the two groups was statistically not significant (p=0.435>0.05, log rank test).

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Survival in Days 1

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116.627 92 134132.250 110 112

8.000 8 0


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DiagnosisMonth from



Figure 7 : Kaplan Meier survival analysis for Month from Diagnosis according to standard treatment (T1) (p=0.005)

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Survival in Days 2

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135.241 52 10963.800 25 8851.000 51 0


1-2020-40

80-100

DiagnosisMonth from



Figure 8 : Kaplan Meier survival analysis for Month from Diagnosis according to test treatment (T2) (p=0.531)

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Survival in Days 1

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32.889 18 10114.379 63 156146.346 117 70


10-3040-6070-90

ScoreKarnofsky



Figure 9 : Kaplan Meier survival analysis for KPS according to standard treatment (T1) (p=0.001)

Patients were divided into 3 groups based on their Karnofsky performance score (KPS) ; Group 1 (10-30), Group 2 (40-60), Group 3 (70-90). 9 patients belong to Group 1, 29 patients and 26 patients belong to Group 2 and 3 respectively. Figure 9 shows that, according to standard treatment (T1), the median survival time for KPS (10-30) was 18 days, 63 days for KPS (40-60) and 117 days for KPS (70-90). Survival difference between the KPS scores was statistically significant (p=0.001<0.05, log rank test).

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Survival in days 2

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25.154 21 1873.480 45 61

232.692 133 256


10-3040-6070-90

ScoreKarnofsky

Survival Plot for Survival in days T2


Figure 10 : Kaplan Meier survival analysis for KPS according to test treatment (T2) (p=0.000)

Meanwhile, for test treatment, 13 patients belong to Group 1, 25 patiens and 26 patients belong to Group 2 and 3. The median survival time for KPS (10-30) was 21 days, 45 days for KPS (40-60) and 133 days for KPS (70-90). The Figure 10 also shows that the survival difference between the KPS scores was statistically significant (p=0.000<0.05, log rank test).

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Survival in Days

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ent 120.591 95 121

105.600 56 141


NoYes

TherapyPrior



Figure 11 : Kaplan Meier survival analysis for Prior Therapy according to standard treatment (p=0.700)

For standard treatment, the median survival time for patients with prior therapy is 56 days (Figure 10). Meanwhile the median survival time for patients with no prior thearpy is 95 days. Survival difference between the two groups was statistically not significant (p=0.700>0.05, log rank test).

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Survival in Days 2

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ent 104.277 52 86

194.882 51 182


NoYes

TherapyPrior



Figure 12 : Kaplan Meier survival analysis for Prior Therapy according to test treatment (p=0.348)

Figure 12 shows that for test treatment, the median survival time for patients with prior therapy is 51 days. Meanwhile the median survival time for patients with no prior thearpy is 52 days.

Survival difference between the two groups was statistically not significant (p=0.348>0.05, log rank test).

Figure 13 aboves, is the result of testing the prognostic factor that influence the risk of death in the VA lung cancer using Cox Proportional Hazard Model.

The proportional hazards regression model for the ith individual of male patients are then

Where the subscript i on an explanatory variables represents the value of that variable for ith individual.

From the result that obtained in MINITAB, it can be concluded that K.S referred to Karnofsky Score has p-value (p=0.000) that have big influence on the hazard of death or survival times of a patients. Based on this output also, we can performed our new model with the known parameters obtained from the result.

Figure 13 : Cos Proportional Hazard

Regression with Life Data: S.D versus treat, C.T, K.S, M.D, Age, prior

Response Variable: S.D

Censoring Information CountUncensored value 128Right censored value 9

Censoring value: Status = 0

Estimation Method: Maximum Likelihood

Distribution: Exponential

Regression Table

Standard 95.0% Normal CIPredictor Coef Error Z P Lower UpperIntercept 3.14891 0.710360 4.43 0.000 1.75664 4.54119treat -0.184342 0.182451 -1.01 0.312 -0.541940 0.173257C.T -0.136463 0.0747321 -1.83 0.068 -0.282936 0.0100087K.S 0.0353214 0.0049785 7.09 0.000 0.0255636 0.0450792M.D -0.0029654 0.0089507 -0.33 0.740 -0.0205085 0.0145776Age 0.0010820 0.0090893 0.12 0.905 -0.0167327 0.0188968prior 0.0111529 0.0218412 0.51 0.610 -0.0316551 0.0539610Shape 1

Log-Likelihood = -724.014

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