广泛期小细胞肺癌的临床特征及预后因素分析

目的:回顾性分析广泛期小细胞肺癌患者的临床特征及影响预后的相关因素，以期为临床决策提供参考。方法:收集2011年3月1日至2016年3月1日于辽宁省肿瘤医院住院治疗的广泛期小细胞肺癌患者的临床资料,分析影响其预后的相关因素。结果:本研究全组175例患者的中位生存时间是14.3个月，1年、2年、3年生存率分别为60.6%，28.6%，10.2%。单因素分析提示PS评分、转移灶数量、骨转移、肝转移、血清CEA、NSE、CYFRA21-1水平，一线化疗疗效、一线化疗周期数，胸部放疗及PCI是广泛期小细胞肺癌预后的影响因素。COX分析提示肝转移、血清NSE、一线化疗周期数，一线化疗疗效，胸部放疗是广泛期小细胞肺癌预后的独立因素。结论:一线化疗周期数≥4，一线化疗疗效达CR，进行胸部放疗的患者预后更佳，初始治疗前血NSE升高、肝转移的患者预后不良。

Clinical characteristics and prognostic factors of extensive-stage small cell lung cancer

Objective:To retrospectively analyze the clinical factors of patients who have extensive-stage small cell lung cancer,and the prognosis factors in order to provide reference for making clinical decision.Methods:The clinical data of patients who were diagnosed with extensive small cell lung cancer and were hospitalized in Liaoning Provincial Cancer Hospital from March 1,2011 to March 1,2016 were collected.The prognosis factors were analysed.Results:The median survival time of the 175 patients in this study was 14.3 months.The 1-,2-,and 3-year survival rates were 60.6%,28.6%,and 10.2%,respectively.Univariate analysis indicated that the prognostic factors in long-term small cell lung cancer were PS,number of organ metastasis bone metastasis,liver metastasis,serum CEA,NSE,CYFRA21-1 levels,first-line chemotherapy efficacy,first-line chemotherapy cycle,chest radiotherapy and PCI were the prognostic factors for long-term small cell lung cancer.COX multivariate analysis indicated that liver metastasis,serum NSE,first-line chemotherapy cycle,first-line chemotherapy efficacy,and chest radiotherapy were independent prognostic factors in long-term small cell lung cancer.Conclusion:When the length of first-line chemotherapy cycles was≥4 weeks,the efficacy of first-line chemotherapy was CR,the patients who have undergone chest radiotherapy have better prognosis.The prognoses of patients with increasing NSE before initial treatment and liver metastases are unfavorable.