老年非小细胞肺癌病人疗效分析

目的 探讨70岁以上老年非小细胞肺癌病人手术、辅助化疗的效果及预后的特点.方法 将70岁以上手术治疗的老年非小细胞肺癌病人按照性别、分期、病理类型、手术方式、是否接受辅助性化疗5个因素与年轻病例进行1:1匹配.用Kaplan-Meier法统计生存率,Log-rank进行差异性检验,用Pearson χ2检验分析手术死亡率及术后短期死亡率在两组人群中的分布差异.结果 共有1304例符合条件并完成匹配,≥70岁者652例,＜70岁者652例.两组总的5年生存率差异无统计学意义(P=0.056),两组之间手术死亡率差异无统计学意义(P=0.265),术后短期死亡率差异有统计学意义(P=0.003),经辅助化疗后两组人群5年生存率大致相等(49.40%对43.89%,P=0.096),两组人群均受益(P=0.049;P=0.000).结论 有手术指征的老年非小细胞肺癌病人应积极手术治疗,术后应行辅助化疗,老年病人经恰当的综合治疗后效果不比年轻者差.

The outcome of non-small cell lung cancer in the elder patients

Objective To evaluate the surgical outcome of non-small cell lung cancer (NSCLC) in the elder patients.Methods A total 8941 surgically treated patients with lung cancer were analyzed retrospectively.Patients with NSCLC elder than 70 years old were matched 1:1 to younger controls for gender,stage,histology,type of pulmonary resection,and whether receiving chemotherapy.Kaplan-Meier was used to determine the survival.Statistical comparisons between curves were performed using the Log-rank test.Pearson chi-square test was used to compare the differences of distribution of the operative mortality and the short-term death rate after the surgery between the two groups of patients.Results There were 1304 patients who met the criteria and be matched,652 were 70 years or older,652 Were younger than 70 years.The overall survival between the two groups of patients showed no significant differences (P=0.056).There were no significant differences in operative mortality rate between the two groups (P=0.265),but the short-term death rate within 2 months after operation in the two groups of patients were significantly different (P=0.003).There was no significant difference in thle 5-year survival rate (49.40% Vs 43.89% P=0.096) after adjuvant chemotherapy,both groups profited from the adjuvant chemotherapy (P=0.049;P=0.000).Conclusion Because the short-term risks and long-term survival are similar,the elderly NSCLC patients who were qualified for surgery treatment should not be denied surgical resection and adjuvant chemothempy based on their chronologic age alone.The effect was not significantly different as compared with their younger counterparts.