93例广泛期小细胞肺癌(SCLC)综合治疗的预后因素分析

Multivariate analysis of prognostic factors in 93 patients with extensive- stage small cell lung cancer( SCLC)

目的:回顾性分析我院93例广泛期SCLC放化综合治疗的疗效,对影响小细胞肺癌预后的多个因素进行分析。方法:选取2008年10月-2010年10月,陕西省肿瘤医院放疗科收治的经病理学或细胞学证实的93例广泛期SCLC患者,患者均采用放化综合治疗。对比风险模型进行多因素分析。主要收集患者的年龄、性别、分期、PS评分、转移部位、胸部放疗情况、化疗周期、预防性脑放疗情况,观察中位生存时间、总生存时间。结果:93例患者的1年生存率39.8%,2年生存率11.8%,3年生存率2.18%,中位生存期11.56个月。单因素分析显示PS评分、胸部放疗、预防性脑放疗、化疗周期数、脑转移对患者的生存期有影响。多因素分析显示PS评分、预防性脑放疗、化疗周期数是预测广泛期小细胞肺癌预后的因素。结论:对于广泛期小细胞肺癌患者PS评分<2、化疗周期数≥4、预防性脑放疗均提示其预后较好。

Objective：To retrospectively review the prognostic factors for 93 patients who underwent the multimo-dality treatment of radiothrapy combined with chemotherapy. All the factors were analyzed by Kaplan-Meier and COX multivariate propotional hazards model. Methods：Retrospective study was carried on 93 patients with small cell lung cancer in extensive-stage from October of 2008 to October of 2010 in Shaanxi Province Tumor Hospital. The multiva-riate analysis was performed with Coxˊs proportion risk model. To analyze the general status,stages,PS score,metastat-ic sites,chemotherapy cycles,prophylactic cranial irradiation,median survival time and overall survival. Results：The overall 1-year survival rate was 39. 8%,2-year survival rate was 11. 8% and 3-year survival rate was 2. 18%. The median survival time was 11. 56 months. The univariate analysis showed that PS score,the absence or presence of brain metastasis,chemotherapy times,thoracic radiotherapy,prophylactic cranial irradiation were related to survival period. The multivariate analysis indicated that the number of chemotherapy,prophylactic cranial irradiation,and PS score were related to the prognosis of patients. Conclusion：The patients who can accept more than four cycles chemo-therapy or accept prophylactic cranial irradiation or PS score 0 -1 have longer survival time and they would benet from multi-treatment modalities.