晚期非小细胞肺癌Buckley-James模型生存分析

目的 探讨影响晚期非小细胞肺癌患者生存时间的因素并建立生存时间预测模型.方法 分析2004-2006年南通大学附属医院初治的184例晚期非小细胞肺癌患者的临床资料,采用Buckley-James生存分析(B-J)模型对可能影响预后的因素进行筛选,运用log-rank检验对患者的实际生存时间与预测时间进行比较.结果 B-J模型因素筛选结果显示,KPS评分、临床分期、治疗方式以及治疗前血红蛋白水平是晚期非小细胞肺癌患者生存时间的主要影响因素,回归方程为lnMONTH=0.0108 KPS评分+0.0238血红蛋白+0.4614Ⅲb期+0.8027Ⅲa期+0.3869(放疗+化疗)+0.507(放疗+手术)+0.6082(化疗+手术)-2.098.所建立的生存时间预测模型与实际生存时间比较,差异无统计学意义(P=0.575＞0.05).结论 KPS评分、临床分期、治疗方式以及治疗前血红蛋白水平均可能影响患者的预后,所建立的生存时间预测模型具有实际意义.

Survival analysis on advanced non.small cell Iung cancer with a Buckley-James model

Objective To analyze the risk factors related to survival time of advanced nonsmall cell lung cancer(NSCLC)and to establish a prediction model on survival time. Methods From 2004-2006, 184 patients with advanced NSCLC were enrolled in the Affiliated Hospital to the Nantong Midical College. Related risk factors were analyzed, using the Buckley-James model. Both actual and predicted survival time were compared by log-rank test. Results Through Buckley-James model analysis, data showed that KPS, clinical stage, treatment and pre-treatment hemoglobin were main influencing factors on survival time. Regression equation appeared to be lnMONTH=0.0108 KPS+0.0238 HB+0.4614 Ⅲb+0.8027 Ⅲa+0.3869(radiotherapy+chemotherapy)+0.507 (radiotherapy + operation)+ 0.6082(chemotherapy + operation)- 2.098. There was no statistical difference between the prediction and the actual models of survival time by log-rank test(P=0.575＞0.05). Conclusion KPS, clinical stage, treatment and pre-treatment hemoglobin might be associated. Both the prognosis of patients with advanced NSCLC and the prediction model seemed to have practical significances.