227例晚期非小细胞肺癌患者的预后因素分析

Prognostic factor analysis of 227 cases with advanced non-small cell lung cancer

目的探讨晚期非小细胞肺癌(NSCLC)患者的生存情况及预后因素。方法回顾性分析227例晚期NSCLC患者的临床资料,采用Kaplan-Meier法及Cox多因素回归模型分析患者预后的影响因素。结果患者的中位生存期(MST)为18.7个月,1、2、3、5年生存率分别为62.1%、39.4%、25.4%、10.1%。单因素分析显示,病理类型、肺部手术、靶向治疗、中药治疗、中药联合靶向治疗、表皮生长因子受体(EGFR)基因状态均可能与晚期NSCLC患者的生存期有关(P<0.05)。Cox多因素分析结果显示,病理类型、中药治疗、肺部手术及中药联合靶向治疗是NSCLC患者预后的独立影响因素(P <0.05)。结论晚期NSCLC患者应积极检测EGFR基因状态,如果存在敏感突变应服用靶向药物。晚期患者应长期服用中药,不应过分追求肺部手术。

Objective To investigate the survival status and prognostic factors in patients with advanced non-small cell lung cancer(NSCLC).Method The clinical data of 227 patients with advanced NSCLC were retrospectively studied,and the prognostic factors were analyzed by Kaplan-Meier method and Cox multivariate proportional hazards model.Result The median survival time(MST) was 18.7 months and the 1-,2-,3-,and 5-year survival rates were 62.1%,39.4%,25.4%,and 10.1%,respectively.Univariate analysis showed that,pathological type,lung surgery,targeted therapy,traditional Chinese medicine(TCM) therapy,TCM combined with targeted therapy,epidermal growth factor receptor(EGFR) status were likely associated with the survival of patients with advanced NSCLC(P<0.05).Cox multivariate analysis indicated that,pathological type,TCM therapy,lung surgery and TCM combined with targeted therapy were the independent prognostic factors in this cohort of NSCLC patients(P<0.05).Conclusion Patients with advanced NSCLC should be actively tested for EGFR gene status and should be given targeted therapy if there are sensitive mutations.TCM is recommended,however,for those with advanced diseases,and lung surgery is not advised to be administered without cautious evaluations.