转移性非小细胞肺癌患者不同生存期预后分析

The prognosis factors in advanced non-small cell lung cancer patients

目的通过比较晚期非小细胞肺癌不同生存期的患者一般特征，分析影响晚期非小细胞肺癌的长期生存的因素。方法回顾性分析浙江省肿瘤医院2005～2010年初诊为晚期非小细胞肺癌的251例患者。对生存期〈6个月与生存期〉2年的两组患者年龄、性别、吸烟、病理分型、治疗方法、TN分期、转移部位数、PS评分、是否脑转移、并发症等方面进行Logistic回归分析。应用Kaplan-Meier法及Log-rank检验进行生存比较。COX多因素分析对全组251例患者进行多因素分析。结果251例患者中位生存时间为10．48个月，1年生存率、2年生存率、5年生存率分别为17．53％、10．4％、2．79％。共44例（17．53％）患者生存期超过2年，其中超过5年的患者为7例（2．79％），74例（29．48％）患者生存期短于6个月。生存期〈6个月与〉2年的患者在性别、病理、治疗方法、N分期、转移部位数、PS评分、脑转移方面差异具有显著性。COX多因素分析显示，淋巴结转移为NO或N1（P=0．000），PS评分为0～1（P=0．000），多学科治疗（P=0．01），单发肺内或骨转移（聘0．00），非吸烟（P=-0．019）是患者长期生存的有利因素。结论淋巴结转移为NO或N1、PS评分为0-1、单一肺内或骨转移、接受多种治疗方法、女性、腺癌可能作为预测晚期非小细胞肺癌长期生存的因素。

Objective To compare the difference between long term survivors（LST） and non-LST. To evaluate the rea- son which influence advanced non-small lung cancerpatients. Methods A total of 251 patients with advanced non- small lung cancer from 2005 to 2010 was reviewed.Compared the two arms with age, sex, smoking, pathology, ther- apy method, T tagging, N staging, performance status, brain metastasis and compliacations with logistic. The survival curves for all patients were estimated according to the Kaplan-Meier method. A multivariate analysis of the clinical factors for 251 patients. Results The MST 1-year, 2-year and 5-year survival rates for 251 patients was 10.48 months, 17.6%, 10.4%, 3.79%. there were 44 cases who survivor more than 2 years and 74 less than 6 months ,7 cases were more than 5 years. The age,sex,pathology therapy method, T staging,N staging, performance status,brain metastasis metastasis were different between the LTS and non-LTS. The good factors by COX regression model for these 251 patients with lung metastasises was found to be carrelated with early N, good PS,muhitherapy,single bone or lung metastasis, EGFR-TKI therapy and non-smoking. Conclusion Good PS, adnocarcinomas, female, single lung or bone metastasis, muhitherapy and early N may predict the long term surviors as factors.