局部晚期非小细胞肺癌患者放化疗的预后相关因素分析

目的 探讨接受放化疗的局部晚期非小细胞肺癌(LA-NSCLC)患者的预后影响因素,为LA-NSCLC的临床诊疗和预后评估提供参考。 方法 回顾性分析177例LA-NSCLC患者的临床资料。采用Kaplan-Meier法生存率进行估计,Log-rank法进行单因素生存分析。多因素分析采用Cox逐步回归模型。 结果 患者的中位生存时间为23月,1,2及3年的生存率分别为81.7%,47.6%及34.5%。单因素分析显示,确诊时双侧锁骨上淋巴结转移、化疗周期数是否足够4周期、有无合并上腔静脉综合征、有无合并慢性阻塞性肺疾病(COPD)与预后有关(均为P<0.05); 多因素分析显示,化疗周期数是否足够4周期、放疗总时间是否超过预期完成总时长1周、有无合并COPD是影响LA-NSCLC患者预后的独立因素(均为P<0.05)。 结论 化疗周期数少于4周期、放疗延迟时间>1周、治疗前合并COPD等是LA-NSCLC患者预后不良的独立影响因素。

Prognostic Factors of Radiotherapy and Chemotherapy in Patients with LA-NSCLC

Objective To investigate the prognostic factors of patients with locally advanced non-small cell lung cancer(LA-NSCLC)undergoing chemoradiotherapy, and provide reference for clinical treatment and prognosis of LA-NSCLC. Methods The clinical data of LA-NSCLC treated from January 1, 2012 to June 30, 2016 in Fujian Provincial Cancer Hospital Affiliated to Fujian Medical University were retrospectively analyzed. The survival rate was estimated by Kaplan-Meier method and the single factor survival was analyzed by Log-rank method. Multivariate analysis was performed using Cox stepwise regression model. Results A total of 177 cases met inclusion criteria. The median survival time was 23 months. The 1-year, 2-year, and 3-year survival rates were 81.7%, 47.6%, and 34.5%, respectively. Univariate analysis suggested that bilateral supraclavicular lymph node metastasis, whether the number of chemotherapy cycle was 4, presence of superior vena cava syndrome, presence or absence of chronic obstructive pulmonary disease(COPD), affected prognosis(all P<0.05). Multivariate analysis suggested that whether the number of chemotherapy cycle was 4 cycles, total duration of radiation therapy exceeded the expected completion time by 1 week, presence or absence of COPD, were independent factors affecting the prognosis of patients with LA-NSCLC(P<0.05). Conclusions There are some independent factors that affect the prognosis of patients with LA-NSCLC, which are whether the number of chemotherapy cycle is 4, the total time of radiotherapy exceeds the expected completion time by 1 week, and whether there is COPD or not.