椎体转移癌放疗患者的临床特征及预后影响因素分析  

Analysis of clinical characteristics and prognostic factors of patients with vertebral metastatic carcinoma treated by radiotherapy

作　　者：张静 吕东来 周俊平 ZHANG Jing;LU Dong-lai;ZHOU Jun-ping(Department of Oncology,the 105th Hospital of People's Liberation Army,Anhui Medical University,Hefei,Anhui 230031,China)

机构地区：[1]安徽医科大学临床医学院解放军105医院,安徽合肥230031

出　　处：《颈腰痛杂志》2019年第1期1-4,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨椎体转移癌放疗患者的临床特征及放疗后的预后影响因素。方法回顾性研究2013-07-2016-12间我院收治的98例椎体转移癌患者病例,对其临床及随访资料进行分析,总结患者的临床特征,采用Kaplan-Meier法和Cox比例风险回归模型分析椎体转移癌患者预后的影响因素。结果 98例椎体转移癌放疗患者生存期0-42个月,中位生存期8个月,1年生存率32.65%,2年生存率19.21%,3年生存率6.15%。Log-rank单因素分析显示,年龄、KPS评分、非腺癌或鳞癌的病理类型、有内脏转移和椎体转移后未行化疗或靶向治疗为患者显著性不良预后影响因素。多元Cox回归分析显示,年龄≥60岁、KPS评分≤70、非腺癌或鳞癌的其他病理类型、存在内脏转移为椎体转移癌患者预后独立危险因素(P<0.05)。结论年龄、病理类型、KPS评分及有无内脏转移对椎体转移癌放疗患者的预后有重要影响,应采取综合治疗措施。接受系统化疗或靶向治疗在一定程度上改善了患者的生存状态。Objective To explore the clinical features and prognostic factors of radiotherapy for vertebral metastatic carcinoma.Methods From July 2013 to December 2016, the clinical and follow-up data of 98 patients with vertebral metastatic carcinoma in our hospital were retrospectively analyzed. The clinical characteristics of the patients were summarized. Kaplan-Meier method and Cox proportional hazard regression model were used to analyze the prognostic factors in cancer patients with vertebral metastasis. Results The survival time of 98 patients with malignant tumor and vertebral metastasis and radiotherapy was 0-42 months, the median survival time was 8 months, the 1 year survival rate was 32.65%, the 2-year survival rate was 19.21%, and the 3-year survival rate was 6.15%.Log-rank single factor analysis showed that age, physical status score(Karnofsky performance score, KPS), pathological type of nonadenocarcinoma or non-squamous cell carcinoma, no chemotherapy or targeted therapy after vertebral metastasis and visceral metastasis were significant adverse prognostic factors. Multivariate Cox regression analysis showed that age ≥60 years old, KPS ≤70, non-adenocarcinoma or non-squamous cell carcinoma of other pathological types, the presence of visceral metastases were independent prognostic factors in patients with vertebral metastatic carcinoma(P <0.05). Conclusion Age, pathological type, KPS and visceral metastasis have important influence on the prognosis of patients with metastatic carcinoma of the vertebral body. We should take comprehensive treatment measures, receive systematic chemotherapy or targeted therapy. Receiving systematic chemotherapy or targeting therapy can improve the patients.

关 键 词：恶性肿瘤 椎体转移 放疗 预后 回归分析 

分 类 号：R73-37[医药卫生—肿瘤]