摘要
目的通过分析近8年我院收治的2440例非小细胞肺癌病例的基本情况,探讨各期的临床特点及预后因素,以及治疗对预后的影响,用于指导临床实践,为前瞻性临床研究提供依据。
方法收集2000年1月1日一2007年12月31日我院收治的2440例非小细胞肺癌病例。采用世界卫生组织病理学分型标准和UICC的09TNM分期标准来确定肺癌的病理类型和分期。分析各种治疗方式对生存的影响。通过Cox回归分析可能影响非小细胞肺癌生存的各种因素,如性别、年龄、吸烟情况、家族史、生活环境、PS评分、肿瘤分化程度、靶向治疗、病理类型、肿瘤分期、治疗情况、手术类型、同时性放化疗等。
结果2440例非小细胞肺癌的患者的1,3,5年累积生存率分别为68.1%,20.4%和13.3%,中位生存期为13.2月,中位进展期为8.6月。Cox分析表明PS0-1分、病理类型、肿瘤分期、手术治疗、放疗、含铂化疗、完全缓解、部分缓解、术中清扫淋巴结数≥10和TTP>6月为预后独立因素。
结论1.PS0-1分、术中清扫淋巴结数≥10和TTP>6月为预后独立因素;病理类型、肿瘤分期、手术治疗、放疗、含铂化疗、完全缓解、部分缓解作为独立预后因素与文献报道一致。
2.确诊手段、手术类型、IB期辅助化疗、化疗总周期数、总化疗药个数、靶向治疗与非小细胞肺癌患者长期生存存在相关性。同时放化疗与非小细胞肺癌患者长期生存存在相关性与文献报道一致
3.发现家族史、二线单双药治疗、三线治疗疗效、三线TTP等因素和非小细胞肺癌的预后无关。
Objective:To summarise the clinical results of treatment of2440cases of non-small-cell lung cancer from our hospital over a period of8years, investigate the clinical characteristics of each stage and prognostic factors, and treatment impact on prognosis, used to guide clinical practice, provide the basis for the prospective clinical study.
Methods:2440patients with non-small-cell lung cancer treated at our hospital were enrolled in this study.The histology of the tumor was described according to the World Health Organization ciassification,and the stage was defined by the7th edition of UICC-TNM staging system.We analyzed the relationship between different modalities of treatment and survival, and evaluated a number of prognostic variables for overall survial including gender, age, cigarette consumption,tumor family history, living circumstance, performance status score, degree of tumor differentiation, targeted therapy, pathological type, tumor staging, treatment manners,type of surgery,concurrent chemoradiation etc.
Results:The overall1.3,5year survial rate was68.1%,20.4%,13.3%, respectively.The median survial time was13.2months,and the median progress free time was8.6months.Cox regression indicated that PS0-1points,histology, tumor staging, surgical treatment, radiotherapy, platin-containing chemotherapy, complete remission, partial remission, the number of resected lymph nodes≥10and time to progression>6months were the prognostic factors of patients with non-small-cell lurig cancer.
Conclusions:1. PS0-1points, the number of resected lymph nodes≥10and time to progression>6months were the independent prognostic factors of patients with non-small-cell lung cancer. Pathological type,tumor staging, surgical treatment, radiotherapy, platin-containing chemotherapy, complete remission and partial remission as independent prognostic factors consistent with those reported literature.2. Means of diagnosis, type of surgery, adjuvant chemotherapy for stage IB, the total number of chemotherapy cycles, the total number of chemotherapy drugs, targeted therapy and concurrent chemoradiation had the correlation with the long-term survival of the patients with non-small cell lung cancer.3. Family history, odd and even second-line drug treatment, efficacy of three-line therapy,time to progression of three-line therapy did not affect the prognosis of the patients with non-small cell lung cancer.
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