贫血对晚期非小细胞肺癌患者治疗疗效及生存预后的影响

Influence of anemia on treatment efficacy and survival prognosis of patient with advanced non-small lung cancer

目的评估无法手术的晚期非小细胞肺癌患者的血红蛋白水平与治疗疗效及生存预后的关系。方法回顾分析广西肿瘤医院2005年l月至2007年1月接受初次化疗并能随访的无法手术的非小细胞肺癌280例,按性别、临床分期、病理类型分成贫血组和非贫血组。两组样本率的比较采用χ2检验,生存分析采用Kaplan-Meier法和log-rank检验;多因素分析采用Cox逐步回归模型。结果贫血降低化疗临床获益率(P<0.05),无贫血组生存期长于贫血组(P<0.001)。分层分析显示ⅢB期、Ⅳ期及腺癌、未分化癌的生存期差异有统计学意义(P<0.05),ⅢA期及腺鳞癌、鳞癌差异无统计学意义(P>0.05)。Cox模型显示贫血是非小细胞肺癌患者的独立预后因素。结论初次治疗前血红蛋白水平与非小细胞肺癌患者的临床获益率和生存时间相关,贫血是影响非小细胞肺癌患者生存的独立预后因素。

Objectives To investigate the correlation between hemoglobin level and chemotherapy efficacy as well as survival prognosis in patients with unresectable non-small-cell lung cancer （NSCLC）. Methods The clinical data of 280 patients with unresectable NSCLC who were admitted in the Guangxi Tumor Hospital from January 2005 to January 2007 were retrospectively analyzed. The patients were divided into anemia group and non-anemia group, according to their gender, clinical stage and his- topathologieal type. Statistical difference was analyzed by Xz test. Survival analysis was evaluated by Kaplan-Meier and log-rank test. Multivariate analysis was performed by Cox stepwise regression model. Results The clinical benefit rate of chemotherapy in the anemia group was decreased （ P 〈 0.05 ） , and the survival time in non-anemia group was longer than that of anemia group （P 〈0. 001 ）. Between the two groups,the survival time of stage ⅢB/IV ,adenocarcinoma and undifferentiated carcinoma was statistically different （P 〈 0.05 ）, but that of stage Ⅲ A, squamous carcinoma and adenosquamous carcinoma was not significant- ly different （ P 〉 0. 05 ）. The Cox analysis showed that anemia was an independent prognostic factor for NSCLC patient. Con- dusions Hemoglobin level before initial therapy is related to survival time and the clinical benefit rate of patients with NSCLC. Anemia is an independent prognostic factor for NSCLC patients.