化放疗治疗青年和中老年肺癌患者预后的比较研究

目的　探讨化放疗治疗 <4 0岁的青年和中老年肺癌患者的预后及其影响因素。方法　对化放疗治疗的 70例青年肺癌患者 (研究组 )和随机选择化放疗治疗的 82例≥ 4 0岁中老年肺癌患者 (对照组 )的临床资料进行统计分析。生存分析采用Kaplan Meier方法 ,单因素分析采用Logrank检验 ,多因素分析采用Cox模型回归分析。结果　研究组的中位生存期为 10个月 ,2年和 5年生存率分别为 11.1%和 3.1% ;对照组中位生存期为 12个月 ,2年和 5年生存率分别为 2 3.1%和 5 .4 % (P =0 .0 898)。单因素分析显示 ,症状持续时间、误诊持续时间、临床分期、化放疗联合模式、放疗剂量、顺铂 (DDP)剂量、体重减轻和卡氏评分与研究组预后有关 ;而症状持续时间、临床分期、放疗剂量、体重减轻和卡氏评分与对照组预后有关。多因素分析显示 ,临床分期、体重减轻和卡氏评分是两组的独立预后指标 ,而DDP剂量仅是研究组独立预后指标。结论　青年肺癌患者预后与中老年人肺癌患者相似 ,青年肺癌患者的预后指标与中老年肺癌患者有所不同。DDP剂量仅是青年肺癌患者预后指标 ,提示DDP治疗青年人肺癌时有剂量 反应关系。

Comparative study on prognostic factors in young and old lung cancer patients under chemo-radiotherapy

OBJECTIVE: To investigate the differences in prognostic factors between the young and old lung cancer patients treated by chemo-radiotherapy. METHODS: The clinical data were collected from 70 young patients (< 40 years old, the study group) and 82 randomly selected old patients (> or = 40 years old, the control group) treated by chemo-radiotherapy. Survival analysis was done by the Kaplan-Meier method, univariate analysis by Log rank test and multivariate analysis by Cox proportional hazard model, respectively. RESULTS: Median survival time was 10 months in the study group and 12 months in the control group. The 2-year survival rate was 11.1% versus 23.1% and the 5-year survival was 3.1% versus 5.4%, respectively. Univariate analyses demonstrated that symptom duration time, mis-diagnosis duration time, clinical stage, chemo-radiation regimen, radiation dose, DDP dose, weight loss and Karnofsky performance status were associated with the prognosis of the study group, and symptom duration time, clinical stage, radiation dose, DDP dose, weight loss and Karnofsky performance status were associated with that of the control group. Multivariate analyses showed that clinical stage, weight loss and Karnofsky performance status were independent prognostic factors for both groups, but DDP dose only for the study group. CONCLUSION: The overall survival was similar in young and old patient groups; There was some difference in prognostic factors between the two groups; DDP dose was an independent prognostic factor for young lung cancer patients which might bear dose-response relationship.