肺癌骨转移105例预后分析

目的探讨肺癌骨转移患者的临床特征及其与预后的关系,筛选影响预后的独立因素。方法对天津市胸科医院2006年1月至2010年12月诊治的105例肺癌骨转移患者的临床特征及预后进行回顾性分析。应用生存曲线法估计全组患者确诊肺癌和确诊骨转移后的生存率;以对数秩检验Log—rank法和考克斯比例风险模型COX法分别进行单因素和多因素分析,筛选影响患者预后的独立因素。结果自确诊肺癌起,患者的中位生存期为19．0个月,1、2年生存率分别为82．9％、29．5％。自确诊骨转移起,患者的中位生存期为10.3个月,1年生存率为38．1％,2年生存率为12．4％。单因素方差分析显示．确诊肺癌时的临床分期、肺癌原发灶手术、确诊骨转移时体力状态（PS）评分、骨转移后的化疗、酪氨酸激酶抑制剂治疗、双磷酸盐治疗与预后相关（P〈0．05）。多因素方差分析显示,确诊肺癌时的临床分期、确诊骨转移时的PS评分、骨转移后的化疗是影响预后的独立因素。结论肺癌骨转移患者的总体预后差,确诊肺癌时临床分期较早、确诊骨转移时PS评分为0～1分、骨转移后接受化疗的患者可能预后相对较好。

Prognostic analysis of 105 patients with bone metastasis from lung cancer

Objective To explore the relationship between the clinical features and the prognosis of patients with bone metastasis from lung cancer, and screen independent factors affecting prognosis. Methods Retrospective analysis of clinical feature and prognosis was conducted on 105 patients with bone metastasis from lung cancer,who were treated in Tianjin Chest Hospital from January 2006 to December 2010. Survival cure was used to estimate the cumulative survival rate after diagnosis of lung cancer and bone metastasis. The Log-rank test and Cox proportional hazards model were used for univariate analysis and multivariate analysis respectively to further screen the independent factors affecting the prognosis of the patients. Results Since diagnosis of lung cancer, the median survival time of the patients was 19.0 months,and the survival rate was 82.9% for 1 year and 29.5% for 2 years respectively. Since diagnosis of bone metastasis, the median survival time was 10.3 months, and the survival rate was 38.1% for 1 year and 12.4% for 2 years. One-way analysis of variance analysis showed than the factors relevant to the prognosis included clinieal stages at the time of diagnosis of lung cancer, the surgery of primary lesion of lung cancer, performance status （PS） at the time of diagnosis of bone metastasis, chemotherapy after bone metastasis, treatment of tyrosine kinase inhibitors （TKI） and treatment of bisphosphates（P〈0.05）. Multivariate analysis of variance demonstrated showed that the independent prog- nostic factors included clinical stages at the time of diagnosis of lung cancer,PS at the lime of diagnosis of bone metastasis and chemotherapy after bone metastasis. Conclusion The overall prognosis of the patients with bone metastasis from lung cancer is poor. The patients with early clinical stages,PS score of 0-1 or receiving chemotherapy after bone metastasis may have relatively good prognosis.