Do trace element levels have prognostic value in non-small cell lung cancer patients treated with chemoradiotherapy?

PURPOSE To determine the prognostic value of trace element levels in cases with locally advanced non-small cell lung cancer (NSCLC). METHODS This prospective study included patients receiving chemoradiotherapy for locally advanced NSCLC and healthy individuals as control group. In both groups, 37 trace element levels in hair were studied by inductively coupled plasma-mass spectrometer technique. Treatment response and survival were evaluated and possible relationship between them and trace element levels was investigated. RESULTS The mean age was 58.01 ± 7.7 years in the patient group (N=70) and 56.3 ± 9.03 years in the control group (N=85). When trace element levels were compared, it was found that there was significant differences between groups regarding Al, As, Be, Ca, Cr, Hg, Li, Ni, Rh, Sb, Se, Sn, Ti and Zn levels (p<0.05; Student's t-test). In the patient group, mean overall survival (OS) and progression-free survival (PFS) were 16.3 and 11.4 months, respectively. After concurrent chemoradiotherapy, complete response (CR) was detected in 7 patients (10%), partial response(PR) in 16 (22.9%), stable disease (SD) in 18 (25.7%) and progression (PD) in 29 patients (41.4%). In univariate and multivariate analyses, Au and Cu levels were significantly associated with PFS (p-0.017 and p=0.020, respectively). CONCLUSION An increase was noticed in heavy metal levels in patients with NSCLC. Copper and gold affected significancy PFS while other trace elements had no significant impact on survival.