摘要
目的研究肺癌脊柱转移瘤患者的外科治疗效果及预后情况。方法回顾性分析2010年至2014年6月收治的63例肺癌脊柱转移患者的手术临床资料。根据治疗方法不同分为手术治疗组48例和保守治疗组15例,比较2组患者治疗前后的疼痛程度、生活质量及神经功能状态。结果手术治疗组患者中位OS为9.8个月,1年OS为39.8%,2年OS为18.7%和5年OS为3.6%。骨转移患者生存期远处转移患者显著延长(P=0.040)。稳定和不稳定骨转移的OS比较无显著差异(P=0.739)。保守组中位数OS为5.0个月,1年OS为22.9%,2年OS为8.8%,5年OS为3.6%。单因素和多因素分析显示,脊柱转移数量对OS存在显著的影响。组织学类型,脊髓病变位置或治疗方案对生存率没有显著影响。手术组患者治疗后疼痛程度和生活质量明显改善。手术组有24例患者术后神经功能明显改善(Z=2.673,P<0.05)。保守组VAS评分及KPS评分中位数均无显著改善。2组治疗效果存在显著差异(P<0.05)。此外,稳定性评估显示,脊柱稳定性对患者的预后无影响(P=0.739)。结论肺癌脊柱转移瘤手术效果显著,手术治疗患者的生活质量和生存时间优于保守组患者。
Objective To study the surgical treatment and prognosis of lung cancer patients with spinal metastases.Methods A retrospective analysis of clinical data of 63 cases of lung cancer patients with spinal metastases after surgery were conducted. According to the different treatment methods,they were divided into surgical group( n = 48) and conservative treatment group( n = 15),the degree of pain between the 2 groups of patients before and after treatment,quality of life and neurological status were compared. Results The surgical treatment group,median OS was 9. 8 months,1-year OS was 39. 8%,2-year OS was18. 7% and 5-year OS was 3. 6%. Survival of patients with bone metastases in patients with distant metastasis was significantly longer( P = 0. 040). There were no significant differences( P = 0. 739) in stable and unstable bone metastasis OS. Conservative group,median OS was 5. 0 months,and 1-year OS was 22. 9%,2-year OS was 8. 8%,5-year OS was 3. 6%. Single factor and multivariate analysis showed that spinal mestastases number had significant influence on OS. Histological type,location,or spinal cord lesion treatment program had no significant effect on survival. In the surgical group,pain and quality of life of patients after surgery improved significantly,and 24 patients were significantly improved in neurological function( Z = 2. 673,P < 0. 05). In conservative treatment group,VAS score and median KPS score were not significantly improved. There had significant difference( P < 0. 05) between the 2 groups in therapeutic effect. In addition,stability assessment showed that stability of the spine had no effect on the prognosis( P = 0. 739). Conclusion Operations for spinal metastases of lung cancer is effective,quality of life and survival of patients treated with surgical treatment are better than that of conservative surgical treatment.
出处
《实用癌症杂志》
2015年第6期837-839,842,共4页
The Practical Journal of Cancer
关键词
肺癌
脊柱转移
手术治疗
预后
Lung cancer
Spinal metastases
Surgery
Prognosis
