用循证医学方法规范晚期非小细胞肺癌的化疗

Chemotherapy in Advanced Non-small Cell Lung Cancer:Using Standard Methods of Evidence-based Medicine Treatment

目的：本文旨在评价用循证医学方法治疗晚期非小细胞肺癌的生存情况及探讨影响晚期肺癌生存和预后的因素。方法：回顾性总结我院2006年1月-2009年6月间收治的120例经病理或细胞学检查确诊的Ⅲb-Ⅳ期初治患者与1999年1月-2005年12月收治的122例经病理或细胞学检查确诊的Ⅲb-Ⅳ期初治患者进行比较,评价其1、2年生存率并进行影响生存和预后的单因素及多因素分析。结果：从症状缓解率和近期总有效率来看,对照组症状缓解率39.3%、近期总有效率27.9%,观察组症状缓解率67.5%、近期总有效率44.2%,两者比较差异有统计学意义;对照组疾病进展时间（TTP）3.5个月,无疾病进展生存期（PFS）2.7个月,中位生存期（MST）7.6个月,1年生存率21.3%,2年生存率9.0%;观察组疾病进展时间为4.7个月,无疾病进展生存期3.2个月,中位生存期12.4个月,1年生存率49.2%,2年生存率18.3%;两组1、2年生存率及中位生存期比较差异有统计学意义,其他比较差异无统计学意义。结论：经临床研究证实,通过应用循证医学方法规范治疗晚期非小细胞肺癌使近期有效率明显提高,生活质量明显得到改善,达到提高治愈率、延长生存期的目的。

Objective：To evaluate the survival status and prognosis factors of chemotherapy in advanced non-small cell lung cancer using standard methods of evidence-based medicine.Methods：A total of 242 cases advanced non-small cell lung cancer in our hospital between January 1999 and June 2009 were retrospectively reviewed patient survival and prognostic factors were analyzed.Results：The effective rate of symptoms and response rate was 39.3% and 27.9% in control group,67.5% and 44.2% in treatment group.There is a significant difference between,with a statistical significance.Progression-free survival and time-to-progression was 2.7 months and 3.5 months in control group,3.2 months and 4.7 months in treatment group.Median survival time and the 1 year、2 years overall survival rates were 7.6 months, 21.3% and 9.0% in control group,12.4 months,49.2% and 18.3% in treatment group.1 year、2 years survival and the median survival between group are significant difference between,with a statistical significance.There was no significant difference compared to other.Conclusion： The clinical studies confirm through the application of evidence-based medicine standard treatment advanced non-small-cell lung cancer that obviously improve the response rate,obviously improved quality of life,prolonged overall survival.