摘要
目的分析局部晚期非小细胞肺癌放化疗后预后影响因素。方法病例选自我院2009年3月至2013年2月首次确诊的119例局部晚期非小细胞肺癌(NSCLC)患者,对所有患者病例资料行回顾性分析,放疗设备为Elekta-6Mv X线直线加速器,放疗方案采用三维适形放疗(3DCRT)或调强放疗(IMRT),放疗剂量为60-70Gy,同步放化疗剂量60Gy,化疗方案为"多西紫杉醇+顺铂或培美曲塞+顺铂",所有患者均给予4-6周期化疗,后进入随访阶段;统计学采用Kaplan Meier法计算总生存率(OS),对可能影响患者预后生存的单因素行分析(Log-Rank检验),P<0.05的单因素行Cox回归多因素分析。结果全组患者1年、2年、3年总生存率(OS)分别为:69.7%、46.2%、16.8%,中位生存时间为22个月。单因素研究结果提示放疗方案、吸烟、肿瘤分期、治疗方案为影响患者生存的主要因素(P=0.016、0.000、0.002、0.001),对有统计学意义的单因素行Cox多因素分析,发现吸烟、肿瘤分期、治疗方案为影响预后生存的独立危险因素(P=0.001、0.002、0.047)。结论同步放化疗、ⅢA期、无吸烟史的局部晚期非小细胞肺癌患者总生存率较佳。
Objective To analyze the prognostic factors of patients with locally advanced non small cell lung cancer （NSCLC） after radiotherapy and chemotherapy.Methods 119 patients of locally advanced NSCLC were diagnosed from March 2009 to February 2013 in our hospital, and all patients were analyzed retrospectively.Elekta-6Mv X-ray linear accelerator was used as radiotherapy equipment, and three dimensional conformal radiotherapy （3DCRT） or intensity modulated radiation therapy （IMRT） was used in the treatment.The dose of radiotherapy was 60-70Gy, and the dose of concurrent radiotherapy and chemotherapy was 60Gy.＂Docetaxel＋Cisplatin/Pemetrexed＋Cisplatin＂ was used in chemotherapy, and all patients were given 4-6 cycles of chemotherapy, and then entered the follow-up period.Kaplan-Meier method was used to calculate the overall survival （OS）, Log-rank method was used for univariate analysis, and Cox regression was used for multivariate analysis.Results The survival rate of 1 year, 2 year and 3 years was 69.7%, 46.2% and 16.8%, respectively.The median survival time was 22 months.Univariate analysis results showed radiotherapy, treatment modality, non smoking, and tumor stage influenced the survival of patients with esophageal cancer （P=0.016, 0.000, 0.002, 0.001）.Multivariate analysis by Cox model showed that treatment modality, non smoking and tumor stage were the independent factors. （P=0.001, 0.002, 0.047）.Conclusion The overall survival rate of patients with advanced non small cell lung cancer is better in the patients with concurrent radiotherapy and chemotherapy, ⅢA phase and non smoking.
出处
《临床肺科杂志》
2017年第8期1481-1485,共5页
Journal of Clinical Pulmonary Medicine
关键词
癌
非小细胞肺癌
同步放化疗
总生存率
预后
carcinoma
non small cell lung cancer
synchronization chemoradiotherapy
overall survival
prognosis
