摘要
背景与目的 综合治疗是改善小细胞肺癌预后的关键。本研究旨在回顾性分析小细胞肺癌患者的预后因素。方法1999年1月~2005年6月,收治一般情况良好(PS=0、1)、经综合治疗(化疗+放疗±手术)且资料完整的253例小细胞肺癌患者,采用Kaplan—Meier法绘制生存曲线,寿命表法计算生存率,COX多因素回归比例风险模型分析患者的预后因素。结果 中位随访23.2月(3~85月)。全组患者1年、3年、5年生存率分别为77.9%、33.8%和23.3%,其中局限期为88.3%、40.2%和31.2%。广泛期为62.9%、22.0%和8.8%。全组中位生存时间为23月(95%CI:19~27月),其中局限期为27月,广泛期为15月。单因素分析发现性别(P=0.0395)、分期(P=0.0000)、治疗初LDH水平(P=0.0000)、手术与否(P=0.0029)、治疗初是否有体重减轻(P=0.0000)以及一线化疗疗效(P=0.0000)等因素可影响患者的生存。多因素分析结果提示,性别(P=0.019)、LDH升高(P=0.000)、手术(P=0.024)和体重下降(P=0.006)是影响患者生存的独立预后因素。结论 对一般行为状态好的小细胞肺癌患者,经综合治疗后,性别、LDH升高、手术和体重下降是影响其预后的主要因素。
Background and objective Multimodality treatment is the milestone of improving the prognosis of patients with small cell lung cancer (SCLC). The aim of this study is to retrospectively review the prognostic factors for SCLC. Methods From January 1999 to June 2005, clinical data were collected from 253 patients who had a good performance status (PS=0-1) and underwent multimodality therapy (chemotherapy+ radiotherapy±surgery), and the prognostic factors were analyzed by Kaplan-Meier and COX multivariate proportional hazards model. Results With a median follow-up of 23.2 months (3-85 months), 1-, 3-, and 5- year survival rate was 77.9%, 33.8% and 23.3% respectively, and 88.3%, 40.2%, 31.2% in LD patients, 62.9%, 22.0% and 8. 8% in ED patients, respectively. Median survival time (MST) of all the patients was 23 months (95% CI: 19-27 months). Univariate analysis indicated that gender (P=0.0395), stage (P=0. 0000), LDH (P=0. 0000), operation (P=0. 0029), weight loss (P=0. 0000) and the efficacy of first-line chemotherapy (P= 0. 0000) significantly influenced survival in SCLC. Multivariate analysis suggested that gender (P=0.019), LDH (P=0.000), operation (P=0.024) and weight loss (P=0.006) were the independent prognostic factors of survival. Conclusion Gender, LDH, operation, and weight loss are the important prognostic factors for patients with SCLC who have a good PS and undergo multimodality treatment.
出处
《中国肺癌杂志》
CAS
2006年第6期525-529,共5页
Chinese Journal of Lung Cancer
关键词
小细胞肺癌
预后
COX比例风险模型
Small cell lung cancer Prognosis COX multivariate proportional hazards model