非小细胞肺癌延迟治疗与预后的关系

Effect of delays on prognosis in patients with non-small cell lung cancer

目的研究非小细胞肺癌首次症状和就诊到开始治疗延迟的时间与预后的关系。方法483例非小细胞肺癌分为两种延迟类型(症状治疗延迟和医院延迟),比较延迟与临床特征的关系和延迟时间影响以及其他相关因素对存活期的影响。结果37%在首次就诊4周内得到治疗,56%在6周内得到治疗。症状到治疗平均延长4.6个月,医院延迟1.4个月。老年人,肿瘤进展期,非手术治疗与较差的生存期相关。症状治疗延迟和医院延迟分别提供其他资料,在其他因素,仅症状治疗延迟与较好预后相关。由于疾病进展,短期延迟与较差预后相关。结论短期延迟与较差预后相关,反映了严重症状和体征的病人得到了合适的治疗,表明非小细胞肺癌病人等待治疗时间比劝告长。

Objective To examine the relation between delay and prognosis in patients with NSCLC and to investigate the delay time from first symptom and from first hospital visit to start the treatment. Methods Two type of delay （symptom to treatment delay and hospital delay）were investigated in 483 patients ,delays in relation to clinical characteristics were compared and the effects of delay times and other relevant factors on survival. Results Thirty seven percent of patients received treatment within 4 weekes of the first hospital visit and 56% within 4 weekes. Median symptom to treatment delay was 4.6 months and median hospital delay 1.4 months. Older age,advanced tumour stage, and non-surgical treatment were independently related to poor survival. Both prolonged hospital delay and symptom to treatment delay provided additional information. Only inceased symptom to treatments delay gave significant information of a better prognosis. There was an association between a short delay and a poor prognosis which was most pronounced in patients with advanced disease. Conclusion Shorter delay was associated with a poorer prognosis that reflect the fact patients with severe signs and symptoms receive prompt treatment. This indicate that the waiting time for treatment in patients with NSCLC is longer than recommended.