Abstract
OBJECTIVES: This study aimed to examine the prognostic role of the plasma 25-hydroxyvitamin D (25(OH)D) level in advanced non-small cell lung cancer (NSCLC) patients treated with platinum-based doublet first-line chemotherapy. METHODS: A total of 195 advanced NSCLC patients were consecutively and prospectively hospitalized to receive platinum-based first-line chemotherapy. The baseline 25(OH)D level was measured at the time of diagnosis. Main outcome measures included overall survival (OS) and progression-free survival (PFS). RESULTS: With 10 ng/mL as the cutoff value for the baseline plasma 25(OH)D level, patients with 25(OH)D < 10 ng/mL (n = 54) and those with 25(OH)D ≥ 10 ng/mL (n = 141) were found to have similar characteristics in terms of age, sex, smoking status, pathological type, Eastern Cooperative Oncology Group (ECOG) performance status, and clinical staging (all P-values > 0.05). The median OS values of patients with 25(OH)D < 10 ng/mL and ≥ 10 ng/mL were 17.9 months (95% confidence interval [CI], 14.4-21.4 months) and 20.8 months (95%CI, 17.9-23.8 months), respectively; the median PFS values were 9.4 months (95%CI, 8.2-10.5 months) and 9.4 months (95%CI, 8.3-10.5 months), respectively. Both univariate and multivariate analyses showed that having a plasma 25(OH)D level < 10 ng/mL was associated with a significantly shorter OS (P = 0.003; P = 0.009), while the baseline plasma 25(OH)D level was not significantly associated with PFS. CONCLUSION: Deficiency of 25(OH)D is an independent prognostic factor for a poor OS in advanced NSCLC patients treated with platinum-based first-line chemotherapy.