***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: OBJECTIVES Blood transfusion has been shown to have deleterious effect on lung cancer survival , but little data are available that assess whether leukocyte-depleted ( LD ) blood has a similar adverse effect . Our institution has been using LD red cells since 2001 . We sought to determine whether LD blood has an effect on survival after resection of early-stage lung cancer . METHODS From a prospect i ve data base , we evaluated all patients with pathologic stage I non-small cell lung cancer . Patients receiving LD blood  were compared with those receiving no transfusion .  Survival was estimated using the Kaplan-Meier method and compared using the log-rank test . Multivariate analysis by Cox regression was used to identify independent risk factors affecting survival . RESULTS From 2001 to 2009 , 361 patients were evaluated ; 63 received LD red cell cell transfusion and 298 received no transfusion .  Median follow-up was 48 months . Disease-free survival ( P < .001 ) and overall survival ( P < .001 ) were worse in patients receiving LD blood . Stratifying for stage , disease-free survival continued to be worse with transfusion for stage IA ( P = .002 ) and IB ( P = .002 ) . Similarly , overall survival continued to be worse with transfusion for stage IA ( P < .001 ) and IB ( P < .001 ) . For disease-free and overall survival , univariate analysis revealed increased age , male gender , anemia , transfusion , and higher stage to be adverse factors , with transfusion and higher stage continuing to be significant adverse factors after multivariate analysis . CONCLUSIONS Our data suggest that transfusion of LD blood is associated with a worse disease-free and overall survival in patients with resected stage I non-small cell lung cancer Background Little is known about prognosis of metastatic patients after receiving a first-line treatment and failure . Our group already showed in pre-treated patients enrolled in phase I clinical trials that a performance status ( PS ) > 2 and an LDH > 600 UI/L were independent prognostic factors . In this prospect i ve study , which included 45 patients , we identified clinical and biological variables as outcome predictors in metastatic Non-Small Cell lung cancer after first line chemotherapy were identified . Findings Forty-five patients that were previously treated for metastatic disease from 12/2000 to 11/2005 in the comprehensive cancer centre ( Centre Léon Bérard ) .  Clinical assessment and blood parameters were recorded and considered . Patient prognostic factors for overall survival ( OS ) with a 0.05- significance level in univariate analysis were entered in a multivariate Cox model for further analysis . Patients ' median age was 58.5 years ( range : 37 - 76 ) . Sixty two percent of the patients were PS = 0 or 1 . After inclusion , nine patients received second-line ( 22.5 % ) , and two received third-line chemotherapy ( 5 % ) . Univariate analysis showed that the factors associated with reduced OS were : PS > 2 , weight loss > 10 % , more than one line of chemotherapy treatment and abnormal blood parameters ( hemoglobin ( Hb ) , platelet and neutrophils counts ) . Multiple regression analysis confirmed that PS > 2 and abnormal hemoglobin were independent predictors for low overall survival . According to the presence of none ( 33 % ) , 1 ( 37 % ) and 2 ( 30 % ) prognostic factors , median OS were 12 , 5 and 2 months respectively . Conclusion From this prospect i ve study , both PS and anemia were found as independent determinants of survival , we found that both PS and anemia were independent determinants of survival . The combination of poor PS and anemia is an effective strategy to predict survival in the case of patients with metastatic NSCLC receiving further treatment after the first line Purpose To evaluate the efficacy of concurrent radiochemotherapy in patients with stage III non-small cell lung cancer ( NSCLC ) , and to examine the effect of hemoglobin levels on survival of those patients . The negative impact of anemia on survival has been noticed for other cancer sites including the head and neck , and the uterine cervix , but it has been rarely described in NSCLC cancer patients treated with radiotherapy . Methods From April 1995 through March 2002 , 56 patients with inoperable stage III non-small lung cancer were treated with radiotherapy consisting of 60 Gy ( 50 Gy+10 Gy boost ) given in 30 fractions of 2 Gy daily , 5 days a week , over a period of 6 weeks , and concurrent low-dose daily chemotherapy ( CHT ) consisting of 6 mg/m2 of cisplatin given Mondays – Fridays during weeks 1–2 and 5–6 . All patients had stage III disease and ages ranged from 39 to 81 years old ( median 63.9 years ) . Results The 2-year and 3-year survival rates were 34 % and 16 % , respectively . Patients with a pretreatment hemoglobin level superior or equal to 11.6 g/dl had a 2-year survival rate of 52 % as compared to 15.5 % for patients with a pretreatment hemoglobin level inferior to 11.6 g/dl ( p=0.0075 ) . Patients with higher KI ( > 70 % ) showed better survival rates than those with lower KI . Surprisingly , patients in stage IIIA did not survive significantly longer than those in stage IIIB . Hematological toxicity ( grade ≥2 ) prevailed ( 25 % ) , followed by esophageal ( 5.4 % ) and bronchopulmonary ( 2 % ) toxicity . Only three patients experienced acute grade 3 hematological toxicity . Because of acute toxic effects , irradiation was interrupted in 8 patients ( 14.3 % ) for 7–13 days ( median 7.5 days ) . Late high- grade ( ≥3 ) toxicity was not found . No grade 4 toxicity or treatment-related deaths were observed during this study . Conclusion Our data show that concurrent radiotherapy with daily low dose cisplatin is well tolerated , and shows survival rates comparable to more aggressive treatment regimens . A combination of this chemotherapy with accelerated hyperfractionated radiotherapy might improve the results in the future . Furthermore , we could show that the hemoglobin levels prior to therapy have an influence on the prognosis , where lower levels were associated with worse outcome . Further trials should consider supplementation with erythropoietin BACKGROUND : According to the literature , performance status , stage-tumor dimension and nodal status , weight loss , were the most important prognostic factors for survival in patients with locally advanced non-small cell lung cancer . AIM : To evaluate the treatment results and the prognostic variables in our patients treated with sequential and concurrent chemoradiotherapy .  MATERIAL AND METHODS : In the study 85 patients were r and omly assigned to one of the two treatment arms . In the sequential arm , 45 patients had previously received  sequential chemotherapy with 4 cycles of and etoposide followed by conformal radiotherapy ( RT ) . In the second concurrent group , 40 patients received  concomitant chemotherapy of cisplatine and etoposide and conformal RT , followed by two cycles of consolidation chemotherapy of carboplatine and etoposide . We described all phases of the conformal three dimensional ( 3-D ) RT . RESULTS : From October 2005 to March 2008 , 93 patients were enrolled . Eight patients were not eligible , seven had stage IV and one patient had pleural effusion . They were all initially considered to have stage IIIB disease . The median survival was 13 months for the patients in the sequential arm and 19 months for those in the concurrent treatment arm . The differences were statistically significant ( log-rank test p=0.0039 ) . The disease-free survival was 9 months in the sequential arm and 16 months in the concurrent treatment group . The differences were statistically significant ( log-rank test p=0.0023 ) . We found that the following prognostic factors significantly influenced the survival in lung cancer patients treated with conservative method : - age , p<0.05 ; - performant status , p<0.001 ; - weight loss , p<0.001 ; tumor dimension , p<0.05 ; and - nodal involvement , p<0.05 . CONCLUSION : In our study , the dose-limiting toxicity , esophagitis was reduced by performing conformal radiotherapy . Conformal thoracic radiotherapy and new radiotherapy technics , such as respiratory gated radiotherapy , allow dose escalating and may probably improve survival and local control in lung cancer patients Introduction : BR.21 demonstrated significant survival benefit for non-small cell lung cancer patients receiving erlotinib compared with placebo .  We undertook to characterize , by exploratory subset analysis , patients less likely to benefit from erlotinib .  Methods : Using stratification and potential prognostic factors , Cox regression with stepwise selection with minimum Akaike Information Criteria was used to separate erlotinib patients into risk categories based on 10th , 50th , and 90th percentiles of prognostic index scores . The hypothesis was that characteristics of treated patients in the highest risk group would be predictive of lack of benefit from erlotinib when comparing erlotinib to placebo patients in the same risk group . Results : Ten factors ( smoking history , performance status , weight loss , anemia , lactic dehydrogenase , response to prior chemotherapy , time from diagnosis , number of prior regimens , epidermal growth factor receptor copy , and ethnicity ) were predictive of overall survival for erlotinib-treated patients and were used in the final model . Four risk groups were derived from the index score of the Prognostic Model : Low Risk ( HR = 0.34 , p < 0.001 ) , Intermediate Low and Intermediate High Risk ( HR 0.76 , p = 0.05 ; HR 0.92 ; p = 0.51 ) and High Risk ( HR 1.07 ; p = 0.78 ) . Median survivals for erlotinib ( placebo ) patients in each group were 20.6 ( 8.9 ) , 10.4 ( 7.6 ) , 4.0 ( 4.1 ) , 1.9 ( 2.3 ) months . The trend test showed that higher risk was associated with shorter survival ( p < 0.001 ) and less treatment effect ( p = 0.03 ) . Conclusions : By establishing a prognostic model , we identified a small group of patients who did not seem to benefit from erlotinib in this study . This model requires prospect i ve validation to confirm that it is both prognostic and predictive of outcome We have evaluated the prognostic value of 22 pretreatment attributes in 436 small cell lung cancer ( SCLC ) patients included in a prospect i ve multicenter study with a minimum 5-year follow-up . Pretreatment clinical and laboratory parameters were registered . Possible prognostic factors were evaluated by univariate analysis ( log rank test ) and by the Cox multivariate regression model . In the univariate analysis of all patients , only age , nodal metastasis , and skin metastasis were not associated with survival . The multivariate Cox model identified gender , extent of disease , performance status ( PS ) , weight loss , platelet count , LDH , and NSE as independent prognostic factors . In subset multivariate analyses according to extent of disease , we found haemoglobin level , PS , NSE , and total WBC as significant prognostic indicators for survival in limited-stage disease ( LD-SCLC ) , while PS , weight loss , LDH , number of metastases , liver metastases , and brain metastases were identified as independent prognostic factors in extensive-stage disease ( ED-SCLC ) . There was a significant correlation between serum LDH and NSE levels . In conclusion , gender , extent of disease , PS , weight loss , haemoglobin , WBC count , platelet count , LDH , and NSE were all found to be independent prognostic factors for SCLC survival . However , the prognostic value of these factors depends highly on whether all or subsets of SCLC patients are studied PURPOSE The aim of this study was to analyze prognostic variables associated with long-term survival in patients with stage III non-small-cell lung cancer enrolled in a Spanish Lung Cancer Group ( SLCG ) phase II trial . PATIENTS AND METHODS Between May 2001 and June 2006 , 139 patients were enrolled . The initial design included 3 arms : sequential chemotherapy ( CT ) followed by st and ard thoracic radiation therapy ( TRT ; RT ) , concomitant CT/TRT followed by consolidation CT , or induction CT followed by CT/TRT . Based on the results of the Radiation Therapy Oncology Group 9410 trial , the sequential arm was closed . Induction or consolidation therapy comprised docetaxel plus gemcitabine . Concomitant treatment comprised docetaxel plus carboplatin plus 60 Gy TRT . A univariate and a Cox proportional hazard regression analysis of the following 11 variables were performed : age , sex , Eastern Cooperative Oncology Group performance status ( PS ) , histology , forced expiratory volume in 1 second , disease stage , nodal status , hemoglobin level , completion of RT treatment , completion of induction or consolidation plus concomitant treatment  , and RT delay . RESULTS With a median follow-up of 23 months for living patients , median survival was 13.07 months for the consolidation arm and 14.65 months for the induction arm . The 4-year survival rates were 25.37 % and 32.35 % , respectively . Only RT treatment completion ( P < .0001 ) and induction or consolidation plus concomitant treatment completion ( P < .0001 ) were 
    Output:
    
Conclusion A decreased pretreatment haemoglobin level among patients with lung cancer is a prognostic factor of poor survival that can serve as an important indicator in survival prediction , risk stratification and treatment selection .