转移性非小细胞肺癌患者不同生存期预后分析

目的 通过比较晚期非小细胞肺癌不同生存期的患者一般特征,分析影响晚期非小细胞肺癌的长期生存的因素.方法 回顾性分析浙江省肿瘤医院2005～2010年初诊为晚期非小细胞肺癌的251例患者.对生存期＜6个月与生存期＞2年的两组患者年龄、性别、吸烟、病理分型、治疗方法、TN分期、转移部位数、PS评分、是否脑转移、并发症等方面进行Logistic回归分析.应用Kaplan-Meier法及Log-rank检验进行生存比较.COX多因素分析对全组251例患者进行多因素分析.结果 251例患者中位生存时间为10.48个月,1年生存率、2年生存率、5年生存率分别为17.53％、10.4％、2.79％.共44例(17.53％)患者生存期超过2年,其中超过5年的患者为7例(2.79％),74例(29.48％)患者生存期短于6个月.生存期＜6个月与＞2年的患者在性别、病理、治疗方法、N分期、转移部位数、PS评分、脑转移方面差异具有显著性.COX多因素分析显示,淋巴结转移为NO或N1 (P=0.000),PS评分为0～1(P=0.000),多学科治疗(P=0.01),单发肺内或骨转移(P=0.00),非吸烟(P=0.019)是患者长期生存的有利因素.结论 淋巴结转移为N0或N1、PS评分为0～1、单一肺内或骨转移、接受多种治疗方法、女性、腺癌可能作为预测晚期非小细胞肺癌长期生存的因素.

The prognosis factors in advanced non-small cell lung cancer patients

Objective To compare the difference between long term survivors（LST） and non-LST. To evaluate the rea- son which influence advanced non-small lung cancerpatients. Methods A total of 251 patients with advanced non- small lung cancer from 2005 to 2010 was reviewed.Compared the two arms with age, sex, smoking, pathology, ther- apy method, T tagging, N staging, performance status, brain metastasis and compliacations with logistic. The survival curves for all patients were estimated according to the Kaplan-Meier method. A multivariate analysis of the clinical factors for 251 patients. Results The MST 1-year, 2-year and 5-year survival rates for 251 patients was 10.48 months, 17.6%, 10.4%, 3.79%. there were 44 cases who survivor more than 2 years and 74 less than 6 months ,7 cases were more than 5 years. The age,sex,pathology therapy method, T staging,N staging, performance status,brain metastasis metastasis were different between the LTS and non-LTS. The good factors by COX regression model for these 251 patients with lung metastasises was found to be carrelated with early N, good PS,muhitherapy,single bone or lung metastasis, EGFR-TKI therapy and non-smoking. Conclusion Good PS, adnocarcinomas, female, single lung or bone metastasis, muhitherapy and early N may predict the long term surviors as factors.