摘要
目的探讨同期放化疗模式在不同年龄Ⅳ期非小细胞肺癌(NSCLC)中的生存和不良反应。方法回顾分析两项前瞻性研究的282例Ⅳ期NSCLC临床资料,其中完成≥2周期化疗同期胸部放疗剂量≥36 Gy;青年组(≤45岁)为44例、中年组(46~64岁)为161例、老年组(≥65岁)为77例。不同年龄组临床特征的差异应用χ^2检验,Kaplan-Meier法计算生存率并Logrank检验差异和分层分析,Cox模型多因素预后分析。结果老年病例中男性发病率比中年组和青年组更高。不同年龄组1、2、3、5年总生存(P=0.810);相同性别、病理类型、T分期、N分期、器官转移状态、相同化疗周期、原发肿瘤剂量及相似强度综合治疗模式、近期疗效等总生存均相近(P>0.05);不同年龄组治疗相关不良反应发生率相似。多因素分析显示不同年龄对生存无影响(P>0.05)。结论对可耐受同期放化疗综合治疗模式的不同年龄Ⅳ期NSCLC患者,可获得相似的生存利益且不良反应相近。
Objective To analyze the survival and toxicity after concurrent chemoradiotherapy in patients of different ages with stage Ⅳ non-small cell lung cancer (NSCLC). Methods Clinical data of 282 NSCLC patients in two prospective studies were retrospectively analyzed, who completed the protocol (at least 2 cycles of chemotherapy and thoracic radiation doses of ≥36 Gy). Among them, 44 patients were assigned into in the young group (≤ 45 years old), 161 patients in the middle-age group (46-64 years old) and 77 patients in the elderly group (≥ 65 years old). The clinical characteristics of patients among different groups were analyzed by χ^2 test. The overall survival (OS) was calculated by Kaplan-Meier method. Stratified analysis was performed by Log-rank test. Multi-factor prognosis analysis was conducted by Cox’s proportional hazards regression model. Results The incidence of NSCLC in the male patients in the elderly group was higher than that in the middle-age and young groups. The 1-, 2-, 3-and 5-year OS did not significantly differ among different groups (P=0.810). The OS did not significantly differ among patients of the same gender, pathological type, T stage, N stage, metastasis status, same chemotherapy cycle, primary tumor dose and comprehensive treatment and short-term response (all P>0.05). The incidence of adverse events did not considerably differ among different groups. Multivariate analysis demonstrated that age was not an independent factor for survival (P>0.05). Conclusion Patients of different ages with stage Ⅳ NSCLC obtain similar survival benefits and adverse events after concurrent chemoradiotherapy.
作者
付卫旭
欧阳伟炜
苏胜发
马筑
李青松
耿一超
罗大先
杨文刚
胡银祥
栗蕙芹
何志旭
卢冰
Fu Weixu;Ouyang Weiwei;Su Shengfa;Ma Zhu;Li Qingsong;Geng Yichao;Luo Daxian;Yang Wengang;Hu Yinxiang;Li Huiqin;He Zhixu;Lu Bing(Department of Oncology,Affiliated Hopistal of Guizhou Medical University Teaching and Research Section of Oncology,Guizhou Medical University,Guiyang 550004,China;Department of Oncology,Affiliated Hopistal of Guizhou Medical University,Guizhou Cancer Hospital,Guiyang 550004,China;Tissue Engineering and StemCell Research Center of Guizhou Medical University,Guiyang 550004,China)
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2019年第4期262-267,共6页
Chinese Journal of Radiation Oncology
基金
贵州省教育厅创新群体重大研究项目(黔教合KY字[2016]032)
贵州省应用基础研究计划重大专项(黔科合J重大字[2015]2003).
关键词
肺肿瘤/三维放射疗法
预后
不良反应
Lung neoplasm/three-dimensional radiotherapy
Prognosis
Adverse event
