射频消融治疗肺癌的预后及其影响因素分析

Prognosis of 80 patients with lung cancer after radiofrequency ablation treatment and its influencing factors

目的 探讨经皮射频消融（radiofrequency ablation,RFA）治疗肺癌的预后及其影响因素。方法 对2000年至2006年在我院行RFA治疗的80例肺癌患者进行随访,随访时间4～68个月,随访率92.5%。分析11项可能影响生存率的因素,探讨它们与生存率的相关性。生存率影响因素的单因素分析采用Kaplan-Meier模型及Log-rank检验,多因素分析采用COX比例风险模型。结果 根据肿瘤国际抗癌联盟（UICC）分期标准,将80例肺癌患者分为三组：肺原发癌Ⅰ/Ⅱ期（Ⅰ期和Ⅱ期）13例,肺原发癌Ⅲ/Ⅳ期（Ⅲ期和Ⅳ期）50例,肺转移癌17例。分别统计全组和各组RFA治疗后的0.5,1,2,3年生存率,结果显示全组患者分别为72.5%、51.2%、22.2%和12.5%;Ⅰ/Ⅱ期分别为92.9%、85.7%、63.5%和39.7%;Ⅲ/Ⅳ期分别为59.0%、37.8%、11.8%和5.9%;肺转移癌分别为71.4%、50.0%、7.1%和7.1%。Ⅰ/Ⅱ期和Ⅲ/Ⅳ期之间的生存率比较差异有显著性,Ⅰ/Ⅱ期和转移癌之间的生存率差异也有显著性;Ⅲ/Ⅳ期和转移癌之间的生存率差异无显著性。可能影响生存率的11项单因素中4项有统计学意义,分别为年龄、UICC分期、有无结合化疗和病灶有无复发或转移。与生存率相关的多因素有3项,分别为年龄、UICC分期和有无结合化疗。结论 RFA治疗肺癌的预后影响因素为年龄、UICC分期和有无结合化疗,此结果有助于指导RFA在肺癌综合治疗中的应用。

Objective To explore the prognosis of patients with lung cancer after radiofrequency ablation（RFA） treatment and its influencing factors. Methods A total of 80 patients with lung cancer underwent RFA treatment in our department from 2000 to 2006. The follow-up period ranged from 4 to 68 months and follow-up rate was 92.5%, Kaplan-Meier model and Log-rank test were used in univariate analysis and COX regression model was used in multivariate analysis to identify prognostic factors for survival. Results Eighty patients were divided into 3 groups according to UICC standard of lung cancer： 13 cases were in stage Ⅰ or Ⅱ of primary lung cancer;50 cases were in stage Ⅲ or Ⅳ of primary hmg cancer and 17 cases had lung metastatic cancers. The survival rates at half a year, 1 year,2 year and 3 year of the 80 patients were 72.5% ,51.2% ,22.2% and 12.5% respectively. The survival rates in patients with different tumor stages at half a year, 1 year,2 year and 3 year were estimated as follows：92.9% ,85.7% ,63.5% and 39.7% of the patients in stage Ⅰ/Ⅱ ;59.0% ,37.8% , 11. 8% and 5.9% of the patients in stage Ⅲ/Ⅳ;71, d%, 50.0% ,7. 1% and 7.1% of the patients with metastatic lung cancer. There was significant difference in survival rates between palients of stage Ⅰ/Ⅱ and patients of stage Ⅲ/Ⅳ ,as well as between patients of stage Ⅰ/Ⅱ and metastatic lung cancer. There was no statistical difference in survival rates between patients of stage Ⅲ/Ⅳ and metastatic lung cancer. Using univariate analysis, 11 potential factors were analyzed and 4 of them were found significant for survival. These 4 factors were age, UICC stage, chemotherapy and recurrence or metastasis. The 4 factors mentioned above were further analyzed by multivariate analysis model and 3 of them were identified as prognostic factors for survival. These 3 factors included age, UICC stage and chemotherapy. Conclusion The prognosis factors in patients with lung cancer after RFA treatment were age, UICC stage and chemotherapy. This information might be useful for the treatment of lung cancer.