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转移性Ⅳ期非小细胞肺癌患者的生存状况及预后分析
作者:毕良文  张丽珍  赵滑峰  王海静  赵维勇  姚志峰  刘丽英  刘燕 
单位:南京医科大学第二附属医院放疗科  江苏 南京 210011 
关键词: 非小细胞肺 肿瘤转移 存活率&n365bet娱乐官网网址bsp;预后 比例危险度模型 回顾性研究 
DOI:R734.2
出版年,卷(期):页码:2018,33(5):421-425
摘要:

目的 探讨转移性Ⅳ期非小细胞肺癌患者生存状况、影响预后的相关因素以及寡转移与多发转移患者间的生存差异。方法 回顾性分析90例转移性Ⅳ期非小细胞肺癌患者的临床资料,利用Kaplan-Meier法进行生存分析,并进行Log-rank检验,利用比例风险模型(Cox模型)进行多因素分析,筛选出相关因素。结果 90例转移性非小细胞肺癌患者1、2、3和5年总生存率分别为64.4%、21.1%、8.8%和1.1%,中位生存时间为14.5个月。寡转移和多发转移患者的1、2和3年生存率分别为89.4%、34.0%、17.0%和37.2%、6.9%、0%,中位生存时间分别为18个月和8个月,两者总生存率比较,差异具有统计学意义(χ2=27.104,P<0.01)。单因素分析结果显示,患者生存情况在KPS评分、组织学类型、转移状况、化疗周期数(≥4个或<4个)、原发病灶控制情况、靶向治疗及治疗模式方面比较,差异均具有统计学意义(均P<0.05)。多因素分析显示,KPS评分、原发灶已控、靶向治疗、寡转移和靶向治疗参与的治疗模式是预后的独立因素(均P<0.05)。结论 KPS≥70分、原发灶已控和寡转移的转移性非小细胞肺癌患者的生存期较长,是潜在的治疗获益患者。

Objective To study the survival and prognostic factors of patients with metastatic stage Ⅳ non-small-cell lung cancer (NSCLC) and the survival difference between oligometastatic and multiple metastatic patients. Methods The clinical data of 90 patients with metastatic stage Ⅳ NSCLC were retrospectively reviewed. Survival analysis was performed with Kaplan-Meier method and Log-rank test. Cox's proportion risk model was applied to complete multivariate analysis to identify related prognostic factors. Results Of 90 patients,the 1-year,2-year,3-year and 5-year overall survival rates were 64.4%,21.1%,8.8% and 1.1%,respectively,and the median survival time was 14.5 months. Besides,the 1-year,2-year and 3-year overall survival rates were 89.4%,34.0% and 17.0% in the oligometastatic patients,and 37.2%,6.9% and 0% in multiple metastatic patients,respectively. The median survival time was 18 months in the oligometastatic patients,and was 8 months in the multiple metastatic patients (χ2=27.104,P<0.01). Univariate analysis showed that the survival was significantly diffferent in terms of KPS score,histological types,metastasis,chemotherapy cycles (≥ 4 vs <4),primary tumor control, target therapy and therapy modes (all P<0.05). Multivariate analysis indicated that KPS score,primary tumor control,target therapy,oligometastasis and therapy modes were independent prognostic factors (all P<0.05). Conclusion Metastatic NSCLC patients with KPS score ≥ 70,controlled primary tumor and oligometastatic status tend to have longer survival time and may be benefited more from treatments.

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