局部晚期非小细胞肺癌放化疗后复发的相关因素研究

目的探讨局部晚期非小细胞肺癌放化疗后出现局部复发及远处转移的相关因素,为有效控制复发提供临床依据。方法回顾性分析260例经病理明确诊断,行化疗或放化疗联合治疗的局部晚期非小细胞肺癌患者的临床资料及与复发有关的危险因素。结果单因素分析显示年龄、癌胚抗原(CEA)水平升高、贫血、血小板计数、临床分期、T分期、N分期、化疗周期、治疗方式与肺癌复发有关(P<0.20)。多因素Logistic回归分析显示,CEA水平升高、血小板计数升高及晚的临床分期是肺癌复发的危险因素(P<0.05,OR>1);化疗>4个周期、放化疗联合治疗是肺癌复发的保护因素(P<0.05,OR<1)。CEA水平升高、血小板计数升高、晚的临床分期是肺癌远处转移的危险因素(P<0.05,OR>1);化疗>4个周期是肺癌远处转移的保护因素(P<0.05,OR<1)。结论局部晚期非小细胞肺癌患者治疗后绝大多数出现复发,临床病理相关因素中,保护因素有化疗>4个周期、放化疗联合治疗;促使肺癌复发的相关因素有CEA水平升高、血小板计数升高、临床分期ⅢB期。

Analysis of Related Factors for Recurrence of Locally Advanced Non-Small-Cell Lung Cancer Patients after Radiotherapy and Chemotherapy

Objective To investigate the clinicopathologic factors for local recurrence and distant metastasis of locally advanced non-small cell lung cancer(LANSCLC) after radiotherapy and chemotherapy and to provide clinical evidence for controlling recurrence.Methods Clinical data and recurrence-related risk factors of 260 LANSCLC patients who were diagnosed by pathology and who received chemotherapy or combined chemo-radiotherapy were retrospectively analyzed.Results Univariate analysis showed that age,high level of CEA,anemia,high level of platelet,clinical stage,T stage,N stage,fewer chemotherapy cycles and treatment were correlated to lung cancer recurrence(P<0.20).Multivariate analysis showed that high level of CEA,high level of platelet,late clinical stage were important risk factors of lung cancer recurrence(P<0.05,OR>1).More than four chemotherapy cycles and combined chemo-radiotherapy were protective factors for lung cancer recurrence(P<0.05,OR<1).High level of CEA,high level of platelet,late clinical stage were risk factors of lung cancer metastasis(P<0.05,OR>1).More than four chemotherapy cycles was protective factor for lung cancer metastasis(P<0.05,OR<1).Conclusion An overwhelming majority of LANSCLC patients have recurrence after treatment.The protective factors are more than 4 chemotherapy cycles,radiotherapy and combined chemo-radiotherapy.Factors causing recurrence are high level of CEA,increased platelet levels and late clinical stage.