Ⅳ期非小细胞肺癌预后因素分析及胸部放疗的潜在意义

Prognostic factors for survival in stage Ⅳ non-small cell lung cancer and underlying meaning of thoracic radiotherapy

目的:分析Ⅳ期非小细胞肺癌(NSCLC)患者的疗效和预后因素,探讨胸部放疗在Ⅳ期NSCLC治疗中的意义。方法:回顾性分析79例有远处转移并行胸部放疗的Ⅳ期NSCLC患者的临床资料,采用KaplanMeier法计算其生存率,并采用Log-rank检验和单因素预后分析进行分析,对统计学有意义的因素进一步用Cox模型行多因素预后分析。结果:1、2年生存率分别为34.2%、12.3%,中位生存期为10个月。单因素分析结果显示影响Ⅳ期NSCLC预后的因素有是否吸烟、转移灶数、胸部放疗剂量(P=0.021、0.000 1、0.002)。多因素分析显示,转移灶数、胸部放疗剂量是系统化疗并行胸部三维适形放疗(3D-CRT)的Ⅳ期NSCLC的独立预后因素(P=0.002、0.045)。结论:Ⅳ期NSCLC行胸部放疗有潜在的临床意义,并且转移灶数目、胸部放疗剂量是影响其生存的显著预后因素。

Objective：To investigate therapeutic effect and prognostic factors for survival in stage Ⅳ non-small cell lung cancer（NSCLC）.Methods： The clinical data of 79 stage Ⅳ pathologically proven NSCLC patients for the primary radiotherapy based on system chemotherapy were retrospectively analyzed.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 34.2% and 12.3% respectively,with a median survival time of 10 months.At a univariate analysis,cigarette smoking status,metastasis number,radiation dose were significant（P=0.021,0.000 1,0.002）.At multivariate analyses,metastasis number,radiation dose were significant prognostic factors（P=0.002,0.045）.Conclusion：Metastasis number,primary tumor radiation dose are significant prognostic factors on survival in patients with stage Ⅳ NSCLC.Stage Ⅳ NSCLC treated with thoracic radiotherapy had potentially clinical implication.