Ⅲ期非小细胞肺癌预后因素及复发因素分析

Analysis of prognostic and recurrence factors in stageⅢ non-small cell lung cancer

目的 采用回顾性分析方法,对Ⅲ期非小细胞肺癌（NSCLC）的预后因素及复发因素进行分析.方法 我院1999年1月1日-2004年12月31日期间具有明确组织学类型、未经治疗过的Ⅲ期非小细胞肺癌患者175例,经手术、放疗、化疗等治疗后,观察1年、3年、5年生存率,分析预后因素,记录复发时间,分析复发因素.结果 截止到2009年11月9日,随访率95%,仍存活或失访者按截尾计算.整组患者中位生存期20个月,1、3、5年总生存率分别为43%、15%和3%.单因素分析因素T分期、临床分期、是否放化疗结合、放射治疗中断、近期疗效和急性放射性肺炎对总生存率有统计学意义.Cox逐步回归分析表明,临床分期、急性放射性肺炎、近期疗效是影响Ⅲ期非小细胞肺癌放射治疗预后的影响因素.未发现某因素为局部复发的影响因素,临床期别是远处转移的影响因素.结论 初步研究结果表明原发肿瘤临床分期、急性放射性肺炎、近期疗效等因素对Ⅲ期非小细胞肺癌的生存率有明显影响.

Objective A retrospective analysis was carried out to investigate the factors of prognostic and recurrence in stageⅢ non - small cell lung cancer. Methods From January 1,1999 to December 31,2004, 175 cases with stagem NSCLC received definitive radiotherapy and eligible for the analysis. Establishing i year, 3 - year and 5 - year survival rate as endpoints to research the prognosis of NSCLC. Results The investigation was finished at November 9,2009, with a follow - up rate of 95 %, those still alive or lost calculated by censoring. The whole group median survival time was 20 months, 1,3 and 5 year survival rates were 43%, 15% and 3% respectively. Univariate analysis identified 6 significant prognostic clinical factors including T stage, clinical stage, Chemo radiotherapy,radiotherapy interruption, short - term response, acute radiotherapy pneumonia. Cox regression showed that clinical stage, acute radiotherapy pneumonia, shoi＇t - term response were the independent prognostic factor of patients with stage m NSCLC. There is no independent factor associated with local recurrence, clinical stage was an independent factor of distant metastasis. Conclusion The preliminary, study results show that the clinical stage of primary tumor, acute radiotherapy pneumonia, short - term response have a significant effect on the survival rate for patients with Ⅲ NSCLC,which provides a reference for the clinical treatment.