同步放化疗治疗Ⅲ期不可切除老年非小细胞肺癌的临床效果及预后因素分析

Clinical Effect and Prognostic Factors of Simultaneous Radiotherapy and Chemotherapy in the Treatment of Stage Ⅲ Unresectable Elderly Non-small Cell Lung Cancer

目的探讨同步放化疗治疗Ⅲ期不可切除老年非小细胞肺癌(NSCLC)临床效果及预后因素。方法回顾性分析120例Ⅲ期老年NSCLC患者临床资料,入选者均进行同步放化疗,治疗后评估治疗效果,并随访1年,记录短期预后情况。根据预后情况分组,并收集一般资料,分析影响预后的危险因素。结果120例Ⅲ期老年NSCLC患者,治疗总有效率为68.33%(82/120),28例(23.33%)预后不良,预后不良组男性、腺癌、吸烟、有胸膜侵犯、肿瘤直径>3 cm占比均高于预后良好组,差异有统计学意义(P<0.05);两组年龄、合并冠心病、合并COPD、合并巩固治疗等对比,差异无统计学意义(P>0.05);Logistic回归分析:男性、腺癌、吸烟、有胸膜侵犯、肿瘤直径>3 cm,是同步放化疗治疗Ⅲ期不可切除老年NSCLC患者预后不良的独立危险因素(P<0.05且OR≥1)。结论同步放化疗治疗Ⅲ期不可切除老年NSCLC效果确切,但仍存在预后不良情况,主要受性别(男性)、腺癌、吸烟、有胸膜侵犯、肿瘤直径>3 cm等因素影响,临床需予以高度重视。

Objective To investigate the clinical effect and prognostic factors of stage Ⅲ unresectable elderly non-small cell lung cancer(NSCLC) treated with concurrent radiotherapy and chemotherapy.Methods The clinical data of 120 aged NSCLC patients were analyzed retrospectively, All the participants underwent concurrent radiotherapy and chemotherapy, Evaluation of treatment after treatment, And follow up for 1 year, Record short-term prognosis.According to the prognosis, And collect general information, To analyze the risk factors affecting prognosis.Results 120 patients with stage Ⅲ elderly NSCLC,The total effective rate of treatment was 68.33%(82/120),There were 28 cases with poor prognosis, 23.33%;The proportion of male, adenocarcinoma, smoking, pleural invasion, tumor diameter >3 cm was higher than that of the group, difference was statistically significant(P<0.05);Comparison of age, coronary heart disease, COPD、consolidation therapy,(b) The difference was not statistically significant(P>0.05);Logistic regression analysis: men, adenocarcinoma, smoking, pleural invasion, tumor diameter >3 cm were independent risk factors for poor prognosis in patients with stage iii unresectable elderly NSCLC treated with synchronous radiotherapy and chemotherapy(P<0.05 and OR≥1).Conclusion The effect of synchronous radiotherapy and chemotherapy in the treatment of stage Ⅲ unresectable elderly NSCLC is accurate, but there are still poor prognosis, mainly affected by sex(male),adenocarcinoma, smoking, pleural invasion, tumor diameter >3 cm and so on.