非小细胞肺癌骨转移的临床特征及影响预后因素的分析  

Clinical Features and Prognostic Factors for the Patients with Bone Metastases from Non-small-cell Lung Cancer

作　　者：何健[1] 曾昭冲[1] 毕爱红[1] 杨平[1] 

机构地区：[1]复旦大学附属中山医院放疗科,上海200032

出　　处：《中国临床医学》2008年第6期778-780,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:研究非小细胞肺癌(下称肺癌)骨转移患者的临床特征及其相关的预后因素。方法:对1997—2007年间诊治的148例非小细胞肺癌骨转移患者的年龄、初诊时的临床分期、影像学分型、原发灶数目和大小、原发灶是否手术或放化疗、骨转移灶数目、骨转移时血ALP水平、是否伴骨旁软组织转移、是否伴淋巴结转移、是否伴其他脏器转移多项因素进行分析,生存率分析用Kaplan-Meier法,单因素分析采用Log-rank方法,多因素分析采用Cox回归模型。结果:肺癌骨转移生存率:1年为52.2%,2年26.5%,3年21.2%,5年3.7%,中位生存期13个月,单因素分析显示骨转移转移灶数目及骨转移时ALP水平这2项因素的各组间生存率差异均有统计学意义(P<0.05),其余各项间差异均无统计学意义。Cox模型多因素分析结果显示初诊时的临床分期、骨转移时血ALP水平、是否伴其他脏器转移、骨转移灶数目诸因素为独立预后因子与预后有关。结论:本研究提供了有关肺癌骨转移的临床特征、生存结果、预后因素。这些将有助于我们确定合适的照射剂量和分割方式。Objective：To identify clinical features and independent predictors of survival in patients with bone metastases from non small-cell lung cancer （NSCLC）. Methods：We retrospectively analyzed 148 patients with bone metastases from NSCLC between 1997 and 2007. Survival rates were achieved by Kaplan-meier method, univariate analysis was by Log-rank. Multivariate analysis were performed using cox regression models. Results： One , 2 , 3 year survival were 52.2%, 26.5%, 3.7% ,respectively. The median suruival time was 13.0 months for patients with bone metastases from NSCLC. On univariate analysis, number of bone lesions, ALP level were prognostic factors, （P〈0. 05）. On multivariate analysis using Cox regression method, stage, ALP level, other organ metastases, number of bone lesions were prognostic factors. Conclusion：This study provides detailed information about clinical features, survival outcomes, and prognostic factors for NSCLC with bone metastases. These prognostic factors will help in determining which dose and fraction are appropriate.

关 键 词：非小细胞肺癌 骨转移 放射治疗 预后因素 

分 类 号：R734.2[医药卫生—肿瘤]