立体定向放疗Ⅰ期非小细胞肺癌患者的生存质量及预后相关影响因素分析

Analysis of the Related Factors of Stereotactic Radiotherapy on the Quality of Survival and Prognosis of Patients with StageⅠNon-SCC Lung Cancer

目的探讨立体定向放疗Ⅰ期非小细胞肺癌(NSCLC)患者的生存质量及预后相关影响因素。方法回顾性分析接受立体定向放疗的98例Ⅰ期NSCLC患者临床资料。比较患者放射前、放射后3个月生活质量差异,并分析影响立体定向放疗对Ⅰ期NSCLC患者预后的相关因素。结果放疗后呼吸困难、焦虑或抑郁发生率低于放疗前,差异有统计学意义(P<0.05);放疗前、后躯体功能、失眠、咳嗽、食欲减退、疲倦发生率比较,差异无统计学意义(P>0.05)。Ⅰ期NSCLC放疗后5年生存率为53.06%(52/98),单因素分析显示:年龄、肿瘤直径、临床分期、治疗缓解情况与立体定向放疗Ⅰ期NSCLC患者预后相关,差异有统计学意义(P<0.05);多因素分析显示:年龄≥60岁、肿瘤直径>3 cm、临床ⅠB期、治疗未缓解是立体定向放疗Ⅰ期NSCLC患者预后的高危因素(P<0.05)。结论立体定向放疗可有效提高Ⅰ期NSCLC患者生存质量,年龄、肿瘤直径、临床分期、治疗缓解情况是患者预后的影响因素。

Objective To investigate the factors of stereoradiotherapy in stageⅠnon-small cell lung cancer(NSCLC).Methods The clinical data of 98 patients with stageⅠNSCLC treated with stereotactic radiotherapy were retrospectively analyzed.Quality of life before and 3 months after radiation were compared,and analyzed the prognostic factors of stereotactic radiotherapy on patients with stageⅠNSCLC.Results Lower rates of dyspnea,anxiety,or depression after radiation than before radiation,The difference was statistical significant(P<0.05);Comparison of incidence before and after physical function,insomnia,cough,loss of appetite,and fatigue,The difference was not significantly significant(P>0.05);The 5-year survival rate after phaseⅠNSCLC radiation was 53.06%(52/98),Univariate analysis showed that age,tumor diameter,clinical stage,and treatment without remission were related to the prognostic impact of stereotactic radiotherapy on patients with stageⅠNSCLC,The difference was statistical significant(P<0.05);Multivariate analysis showed that:age 60 years old,tumor diameter>3 cm,clinical stageⅠB,and treatment remission were high-risk factors of stereotactic radiotherapy on stageⅠNSCLC patients(P<0.05).Conclusion Steretactic radiotherapy can effectively improve the quality of survival of patients with stageⅠNSCLC,and age,tumor diameter,clinical stage and treatment remission are high risk factors affecting patient prognosis.