非小细胞肺癌骨转移患者用表皮生长因子受体酪氨酸激酶抑制剂治疗的预后因素分析

Analysis of Prognostic Factors of Non-Small Cell Lung Carcinoma Patients with Bone Metastases Treated with Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitor

目的:分析影响应用表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)治疗非小细胞肺癌骨转移患者预后的相关临床因素。方法:回顾分析复旦大学附属中山医院和同济大学附属上海市肺科医院2009年1月—2010年12月应用EGFR-TKI治疗的132例非小细胞肺癌骨转移患者临床资料,用卡普兰-迈耶统计法估计患者1、2年生存率,单因素分析(Log-rank检验)筛选影响患者预后的风险因素,用Cox多因素分析模型进一步确认独立风险因素。结果:132例患者中位生存期15.9个月,1年、2年生存率分别为63.9%、41.5%。单因素分析显示:女性、不吸烟者、血白蛋白值正常者中位生存期显著延长(P<0.05)。多因素分析显示:血白蛋白值是影响患者生存的独立预后因素。结论:对于女性、不吸烟的非小细胞肺癌骨转移患者,应用EGFR-TKI治疗有延长中位生存期的趋势,血白蛋白值低是影响预后的不利因素。

Objective：To analyze the prognostic factors of non-small cell lung carcinoma patients with bone metastases treated with epidermal growth factor receptor tyrosine kinase inhibitor（EGFR-TKI）. Methods： The clinical data of 132 non-small cell lung carcinoma patients with bone metastases treated with EGFR-TKI, admitted in Zhongshan Hospital of Fudan University and Shanghai Pulmonary Hospital of Tongji University during January 2009 to December 2010, were retrospectively researched. Kaplan-Meier analysis was used to estimate the 1-year and 2-year survival rates of patients. Log-rank test was used to screen the survival influencing factors and Cox regression was further used to confirm the independent factors. Results： The median survival of the 132 patients was 15.9 months. The 1-year and 2-year survival rates were 63.9% and 41.5%, respectively. Univariate analysis showed that female, nonsmoker, normal se rum albumin lever were associated with the good prognosis of patients （P〈0. 05）, while multivariate analysis only revealed that serum albumin level was the independent factor of prognosis. Conclesion： The treatment with EGFR TKI tends to prolong the median survival time of non-small cell lung carcinoma patients with bone metastases who are female and nonsmokers. Low serum albumin level is an unfavorable prognostic factor.