老年局限期小细胞肺癌患者预后因素分析

Analysis of prognostic factors in elderly patients with limited-stage small cell lung cancer

目的探讨老年局限期小细胞肺癌的预后相关因素,为临床最佳治疗方案的选择提供参考。方法回顾性纳入2010年1月~2016年12月于河北省唐山市人民医院治疗的79例老年局限期小细胞肺癌,收集性别、年龄、卡氏功能状态(KPS)评分、吸烟史、放化疗模式、预防性脑照射(PCI)情况、化疗周期数等信息,以总生存为研究终点,应用单因素和多因素生存分析选择并确立独立的预后因素。结果79例患者的中位生存期为15.4个月,2年生存率为25.6%。不同性别、年龄、KPS评分、吸烟史、治疗模式等组间生存比较,提示KPS评分、PCI、放疗与化疗联合为预后因素(P<0.05),而年龄和化疗周期数与患者生存具有边缘相关性(0.05<P<0.10)。以上因素纳入多因素分析,结果提示KPS评分、PCI、放疗与化疗联合治疗和化疗周期数为独立的预后因素(P<0.05)。结论好的KPS评分、规范的放化联合治疗、足够的化疗周期数、及时的PCI可以为老年局限期小细胞肺癌患者带来生存的获益。

Objective To explore the prognostic factors related to limited-stage small cell lung cancer in elderly patients,and to provide a reference for the selection of the best clinical treatment plan.Methods A retrospective analysis of 79 elderly patients with limited-stage small cell lung cancer treated in Tangshan People′s Hospital,Hebei Province from January 2010 to December 2016 was performed.The sex,age,Karnofsky performance status(KPS)score,smoking history,radiotherapy and chemotherapy mode,prophylactic cranial irradiation(PCI)situation,number of chemotherapy cycles and other information was collected.The study endpoint was overall survival.Univariate and multivariate survival analyses were used to identify independent prognostic factors.Results The median survival time of the 79 patients was 15.4 months,and the 2-year survival rate was 25.6%.The comparison of survival among different groups including gender,age,KPS score,smoking history,and treatment mode suggested that KPS score,PCI,and combination of radiotherapy and chemotherapy were prognostic factors(P<0.05),while age and number of chemotherapy cycles had marginal correlation with patient survival(0.05<P<0.10).The above factors were included in the multivariate analysis and the results suggested that KPS score,PCI,combined mode of radiotherapy and chemotherapy and the number of chemotherapy cycles were independent prognostic factors(P<0.05).Conclusion Good KPS,standard combination of radiotherapy and chemotherapy,adequate number of chemotherapy cycles,and performing PCI can provide survival benefits for elderly patients with limited-stage small cell lung cancer.