摘要
目的分析157例晚期非小细胞肺癌(NSCLC)的临床资料,探讨影响晚期NSCLC疗效的相关因素。方法采用回顾性分析的方法,将2006年1月至2008年1月在大连医科大学附属第二医院肿瘤科就诊的晚期NSCLC患者纳入研究,分析近期和远期疗效以及影响疗效的相关因素。步骤:(1)统计一线治疗(化疗和靶向)的疾病进展时间(TTP),以性别、年龄、卡氏评分、病理类型作为变量,探讨各变量对近期疗效的影响;(2)入组患者以生存期(OS)分成3组,A组OS约12个月,B组12个月约OS约24个月,C组OS跃24个月。分别以性别、年龄、卡氏评分、临床分期、病理类型、有无恶性胸腔积液、转移部位数目、是否综合治疗为变量进行分层分析,探讨各变量对远期疗效的影响。结果 157例患者,女53例(33.8%),男104例(66.2%);鳞癌46例(29.3%),腺癌99例(63.1%),其他病理类型12例(7.6%);Ⅲb期60例(38.2%),Ⅳ期97例(61.8%)。一线化疗中位TTP4个月,一线靶向中位TTP4个月。中位OS13个月,12个月生存率58.0%,24个月生存率25.5%。卡氏评分是一线化疗TTP的影响因素,卡氏评分≥70分的患者TTP较长,而性别、年龄、病理类型变量均未能影响TTP。一线靶向治疗和一线化疗的近期疗效相近。性别、年龄和卡氏评分均是远期疗效的影响因素,年轻、女性、卡氏评分≥70分的患者12个月生存率及24个月生存率较老年、男性、卡氏评分约70分的患者高。病理类型和转移部位数目对OS的影响无统计学意义;Ⅲb期和Ⅳ期在OS是否大于12个月分组中有统计学意义;157例患者中有无恶性腔积液对OS的影响亦无统计学意义。综合治疗优于单一治疗或不治疗。结论 (1)卡氏评分是一线化疗TTP的影响因素;一线靶向治疗和化疗的近期疗效相近;(2)性别、年龄、卡式评分是远期疗效的影响因素;(3)Ⅲb期和Ⅳ期在OS是否大于12个月分组中有统计学意义;(4)综合治疗优于单一治疗或不治�
Objective To investigate the clinical factors related to the treatment efficacy of advanced non-small cell lung cancer （NSCLC） by analyzing the clinical data of 157 patients with NSCLC.Methods The patients with advanced NSCLC visiting 2nd Affiliated Hospital of Dalian Medical Oncology in Jan.2006-Jan.2008 were included in this retrospective analysis.All relevant factors which have effected on the short-and long-term treatment efficacy were analyzed.The procedures are：1.Statistics analysis of time to progression （TTP） after first-line treatment （chemotherapy and targeted therapy） to investigate the effect of gender,age,Karnofsky score and pathological type on the short-term treatment efficacy of advanced NSCLC.2.Patients were divided into three groups according to survival time,A：less than 12 months;B：more than 12 months and less than 24 months;C：more than 24 months.Stratified analysis were done to analyze the effect of gender,age,Karnofsky score,clinical stage,histological type,malignant pleural effusion,number of metastasis and the combined therapy on the long-term treatment efficacy of NSCLC.Results 157 patients,female 53（33.8%） and male 104（66.2%）;squamous cell carcinoma 46 cases （29.3%）,adenocarcinoma 99（63.1%）,and others 12（7.6%）;stage Ⅲb 60（38.2%） and stage Ⅳ 97（61.8%）;median TTP is 4 months after first-line chemotherapy and first-line targeted therapy;the overall median survival is 13 months;12-month survival rate is 58.0%,and 24-month survival rate is 25.5%;Karnofsky score has impact on the TTP after first-line chemotherapy,the patients having a Karnofsky score ≥70 had longer TTP.Sex,age,and pathological type failed to affect TTP.First-line targeted therapy has similar short-term efficacy as first-line chemotherapy.Age and Karnofsky score were influencing factors on the long-term efficacy of advanced NSCLC.Both 12-and 24-month survival rate were higher in young,female,Karnofsky score ≥70 patients than older,male,and Karnofsky score 〈70 ones.Patholo
出处
《中华临床医师杂志（电子版）》
CAS
2011年第5期23-28,共6页
Chinese Journal of Clinicians(Electronic Edition)
关键词
癌
非小细胞肺
治疗结果
预后
Carcinoma,non-small-cell lung
Treatment outcome
Prognosis
