FEV1/FVC对局限期小细胞肺癌预后的影响

Effect of FEV1/FVC on prognosis of limited stage small cell lung cancer

目的探索FEV1/FVC对于局限期小细胞肺癌的预后影响。方法采取回顾性分析对西安交通大学医学院第一附属医院及武警陕西总队医院2012-01至2015-03收治的小细胞肺癌患者109例,均经EP方案化疗及放疗,治疗前测量肺功能,分为实验组(FEV1/FVC <0. 70)及对照组(FEV1/FVC≥0. 70),评价FEV1/FVC与临床因素,生存期及其影响因素的相关性。结果 FEV1/FVC与患者死亡(P=0. 008),小细胞肺癌的局部进展(P=0. 018)及远处转移(P=0. 025)均有密切的相关性,FEV1%与患者死亡有一定相关性。单因素分析发现,化疗周期、FEV1%、FEV1/FVC对局限期小细胞肺癌的总生存期有明显影响,差异具有统计学意义(P <0. 05)。多因素分析发现化疗周期、FEV1/FVC是影响局限期小细胞肺癌总生存期的独立影响因素。年龄、化疗周期、FEV1%及FEV1/FVC对局限期小细胞肺癌的无进展生存期有明显影响,差异具有统计学意义(P <0. 05)。多因素分析结果显示:化疗周期及FEV1/FVC是影响局限期小细胞肺癌无进展生存期的独立影响因素(P <0. 05)。实验组(FEV1/FVC <0. 70)总生存期明显缩短,两者比较差异具有统计学意义(χ^2=5. 429,P <0. 05)。结论治疗前肺功能FEV1/FVC可能是评价局限期小细胞肺癌患者预后的良好指标。

Objective To explore the effect of FEV1/FVC on the prognosis of limited stage small cell lung cancer.Methods The clinical data on 109 patients with small cell lung cancer treated at the First Affiliated Hospital of Xi’an Jiaotong University and our hospital between January 2012 and March 2015 was analyzed retrospectively. All the patients were treated with EP regimen chemotherapy and radiotherapy. Lung function was measured before treatment. The patients were divided into the experimental group (FEV1/FVC<0.70) and control group (FEV1/FVC<0.70). The correlations of FEV1/FVC with clinical factors, survival time and the influencing factors were evaluated.Results FEV1/FVC was closely related to patient mortality (P=0.008), local progression of small cell lung cancer (P=0.018) and distant metastasis (P=0.025). FEV1 (%) was related to patient mortality. Univariate analysis showed that chemotherapy cycles, FEV1% and FEV1/FVC had significant effect on the overall survival of patients with limited stage small cell lung cancer (P<0.05). Multivariate analysis showed that FEV1/FVC was an independent factor that influenced the overall survival of patients with limited stage small cell lung cancer. Age, chemotherapy cycle, FEV1% and FEV1/FVC had significant effect on progression-free survival of limited stage small cell lung cancer patients(P<0.05). Multivariate analysis showed that chemotherapy cycle and FEV1/FVC were independent factors influencing the progression-free survival of patients with limited-stage small cell lung cancer (P<0.05). The total survival time of the experimental group (FEV1/FVC<0.70) was significantly shortened, and the difference between the two groups was statistically significant (χ^2=5.429, P<0.05).Conclusions FEV1/FVC may be a good prognostic indicator for limited stage small cell lung cancer before treatment.