80岁及以上老年肺癌患者的预后因素及治疗  

Analysis of prognosis and therapy strategy in patients with lung cancer aged 80 years and over

作　　者：郑华[1] 尹颜军[2] 王群慧[1] 史鹤玲[1] 李宝兰[1] 

机构地区：[1]首都医科大学附属北京胸科医院综合科,101149 [2]首都医科大学附属北京胸科医院检验科,101149

出　　处：《中华老年医学杂志》2012年第9期767-770,共4页Chinese Journal of Geriatrics

摘　　要：目的分析80岁及以上老年肺癌患者的预后因素方法分析107例80岁及以上老年肺癌患者临床信息、治疗情况等因素对生存的影响。结果80岁以上老年肺癌患者中位生存期为6．9个月，小细胞肺癌中92．9％（13／14）的患者接受治疗，非小细胞肺癌中34．4％（31／90）的患者接受了治疗。接受有效治疗和支持治疗患者的生存期分别为16．5个月和8．7个月（P=0．008）。早期接受手术患者的生存期为36．7个月，未手术患者生存期为15．5个月（P=0．023）；晚期接受化疗的患者中双药联合化疗患者生存期为13．4个月，单药化疗生存期为4．6个月（P=0．002）；小细胞肺癌中，接受放疗者生存期为12．8个月，未接受放疗者生存期为6．4个月（P=0．049）。单因素生存分析结果显示功能状态评分（PS评分）、临床分期、早期手术、晚期及放疗等因素影响预后（x2=38．236、18．831、5．187、9．827、4．186，均P〈0．05），性别、病理类型等因素不影响预后。COX回归模型进行多因素分析，结果显示仅临床分期（P=0．046）和PS评分（P=0．003）为预后独立影响因素。结论肿瘤分期和患者功能状态是影响老年肺癌患者预后的独立因素。当患者体力状况较好时，可通过手术、联合化疗及放疗等治疗手段生存获益；当体力状况较差时，可选择最佳支持治疗。Objective To analyze the prognostic factors and trerapy strategy of lung cancer in the patients aged 80 years and over. Methods Totally 107 patients aged ≥ 80 years with lung cancer were retrospectively reviewed. Patients＇ clinical characteristics and treatment were analyzed. Results Median survival time of the patients was 6.9 months. 92.9% （13/14） of small cell lung cancer patients and 34.4% （31/90） of non small ceil lung cancer patients were treated. Life cycle of patients who accepted effective treatments and supportive treatments were 16.5 months and 8.7 months, respectively （P=0. 008）. In the early stage of tumors, survival time of patients undergoing surgery was 36.7 months, 15.5 months in patients without surgery （P= 0. 023）, while in the late stage, survival time of patients receiving combined chemotherapy was 13.4 months, 4.6 months in patients receiving single agent chemotherapy（P=0. 002）. In small cell lung cancer, survival time of patients who received radiotherapy was 12.8 months, 6.4 months in patients who did not receive radiotherapy （P=0. 049）. Performance status （PS）, clinical stage, early surgery, late chemotherapy and radiotherapy（x2 =38.236,18.831,5.187,9.827,4.186, P〈0.05）, but not sex and pathology type affected the prognosis. PS score （P= 0. 003） and clinical stage（P = 0. 046） were the independent influencing factors. Conclusions Performance status and clinical stage are the independent influencing factors of lung cancer in the patients aged over 80 years. Patients may improve survival if receiving surgery, chemotherapy and/or radiotherapy when they have good PS, otherwise patients may choose best supportive care.

关 键 词：肺肿瘤 预后 

分 类 号：R734.2[医药卫生—肿瘤]