108例老年晚期非小细胞肺癌患者预后因素分析

目的探讨65岁以上老年晚期非小细胞肺癌(NSCLC)患者的生存状况及预后因素。方法回顾性研究108例65岁以上老年晚期NSCLC患者的临床资料,采用Kaplan-Meier法及Cox回归模型对预后相关因素进行分析。结果截至末次随访时间,随访时间14~74个月,中位随访时间43个月,死亡84例(77.8%),生存21例(19.4%),失访3例(2.8%)。所有患者中位生存期为21.1个月,1年生存率为66.7%,2年生存率为41.7%,3年生存率为29.1%,5年生存率为13.2%。单因素分析显示,美国东部肿瘤协作组(ECOG)评分、病理类型、初始脑转移、初始胸腔积液、肺部手术、表皮生长因子受体(EGFR)敏感突变、靶向治疗、中药治疗与生存期有关(P﹤0.05)。多因素分析显示,病理类型、初始脑转移、初始胸腔积液、肺部手术、中药治疗是老年晚期NSCLC患者生存期的影响因素。结论诊断时合并脑转移、胸腔积液的患者生存期缩短;接受肺部手术、靶向治疗、中药治疗是延长晚期老年NSCLC患者生存期的重要手段。

Multivariate analysis of prognostic factors in the elderly patients with advanced non-small cell lung cancer:a study of 108 patients

Objective To investigate the survival and prognostic factors of elderly patients with advanced non-small cell lung cancer(NSCLC)aged over 65 years.Method A retrospective research was conducted enrolling 108 cases of NSCLC aged over 65.The prognostic factors were analyzed by Kaplan-Meier and Cox multivariate proportional hazards model.Result As of last visit,the duration of follow-up ranged from 14 to 74 months,with a median follow-up time of 43 months;there were 84 cases(77.8%)of death,21 survivors(19.4%),and 3(2.8%)were lost to follow-up.The median overall survival(mOS)of all patients was 21.1 months,and the survival rates for 1,2,3 and 5 years were 66.7%,41.7%,29.1%,and 13.2%,respectively.Univariate analysis showed that Eastern Cooperative Oncology Group(ECOG)score,pathological type,initial brain metastasis,initial pleural effusion,lung surgery,sensitive epidermal growth factor receptor(EGFR)mutation,targeted therapy,and traditional Chinese medicine(TCM)treatment were significantly associated with OS of patients(P<0.05).Multivariate analysis suggested that,pathological type,initial brain metastasis,initial pleural effusion,lung surgery,and TCM treatment were the factors affecting the OS of elderly patients with NSCLC(P<0.05).Conclusion The survival of patients with brain metastasis and pleural effusion at diagnosis is shortened;receiving lung surgery,targeted therapy and TCM therapy are indispensable means to prolong the survival of advanced elderly patients with NSCLC.