41例PET/CT检查发现颅外转移的Ⅳ期非小细胞肺癌治疗结果和预后分析

Outcome and Prognostic Factors for Survival in Stage Ⅳ Non-small Cell Lung Cancer Detected Extracranial Metastasis with PET/CT

目的分析PET/CT检查发现颅外远处转移的Ⅳ期非小细胞肺癌(NSCLC)的治疗结果及预后因素。方法对41例PET/CT定位扫描新发现有颅外远处转移的Ⅳ期NSCLC进行回顾性分析,采用Kaplan-Meier法计算其生存率并logrank法检验和单因素预后分析,采用Cox模型行多因素预后分析。结果 1、2年生存率分别为29.3%、9.8%,全组病例中位生存期10个月,其中23例单发转移组患者中位生存期12个月,18例多发转移组患者中位生存期5个月,2组间生存期差异有统计学意义(χ2=15.889,P=0.000)。多因素分析结果显示影响Ⅳ期NSCLC预后因素有转移灶数、是否吸烟(χ2=13.110、4.213,P=0.000、0.040)。结论 PET/CT检查发现颅外远处转移的Ⅳ期NSCLC患者的中位生存期达10个月,有优于以往报道的Ⅳ期NSCLC患者治疗结果的趋势。转移灶数目、是否吸烟是影响其生存的显著预后因素。

Objective To investigate outcome and prognostic factors for survival in Stage IV non-small cell lung cancer （NSCLC） detected extracranial metastasis with PET/CT. Methods PET/CT （positron emission tomography/computed tomography） scanning was performed in pathologically proven NSCLC patients for radical radiotherapy. PET/CT identified previously undetected extracranial distant metastatic disease in 41 patients. These Stage IV NSCLC were included in this study. The impact of related prognostic factors on survival was evaluated by univariate and multivariate analyses. Results The overall 1-year and 2-year survival rate was 29.3% and 9.8% respectively,with a median survival time of 10 months, 12 months for 23 patients with single PET/CT-detected metastasis and 5 months for 18 patients with multiple metastasis （X2=15.889, P =0.000）. PET/CT-detected metastasis at multivariate analysis, metastasis number, cigarette smoking status were significant prognostic factors （x2=13.110,4.213,P =0.000,0.040）. Conclusion Patients in this study who were found by PET/CT to have stage IV NSCLC disease had a median survival time of 10 months, which was superior to the rate of survival reported in most published series of patients with stage IV NSCLC . Metastasis number, cigarette smoking status were significant prognostic factors on survival in patients with stage IV NSCLC detected extracranial metastasis with PET/CT.