晚期NSCLC一线化疗疾病控制与生存关系的分析

目的回顾性分析一线化疗疾病控制（DCR）与进展（PD）患者之间生存的差别,探讨DCR可否预测生存。方法本文回顾性分析本院一线含铂联合化疗86例ⅢB期/Ⅳ期非小细胞肺癌（NSCLC）患者,化疗的疗效按WHO标准分为CR,PR,SD,PD。结果一线化疗后DCR共64例（74.4%）其中CR 0例,PR 30例（34.9%）,SD 34例（39.5%）],PD 22例（25.6%）。DCR和PD患者中位生存期（MST）有统计学意义,为14.2月和5.1月（P〈0.001）。CR＋PR和SD患者MST有统计学意义,为15.0月和11.0月（P=0.030）。COX多因素回归分析显示一线化疗疾病控制（P=0.017）,ECOG评分（P=0.046）是总生存的独立预后因素。结论本研究提示晚期NSCLC患者一线化疗疾病控制患者其生存较进展患者好,疾病控制比化疗有效似乎更能反映化疗疗效,预测生存期。

Disease control rate and survival in advanced non-small cell lung cancer after first-line chemotherapy

Objective To evaluate the disease control rate （DCR） in predicting survival of patients with advanced nonsmall cell lung cancer （NSCLC） after first-line chemotherapy. Methods Eighty-six patients with stage ⅢB/Ⅳ NSCLC received the third generation platinum-based chemotherapy. The response of first-line chemotherapy was classified as complete response （CR）,partial response （PR）,stable disease （SD） and progression disease （PD） according to WHO criteria. Results After first-line chemotherapy, 64 （74. 4%） patients had disease control, including CR 0, PR 30 （34. 9%）and SD 34 （39.5%） ;while 22 patients （25.6%） had PD. The median survival time of DCR arm was significantly longer than PD arm （14.2 months vs 5. 1 months,P〈0. 001）,and it was different between CR＋PR arm and SD arm （15. 0 months vs 11. 0 months, P= 0. 030）. The COX regression analysis showed that disease control （P= 0. 017） and ECOG （P = 0. 046） were independently prognosis factors of overall survival. Conclusion Disease control rate is of better value in predicting survival than response rate in patients receiving platinum-based chemotherapy for advanced NSCLC.