70岁以上高龄广泛期小细胞肺癌的预后分析  

Treatment and prognosis about extensive disease of small cell lung cancer patients older than 70 years old

作　　者：孟弃逸[1] 吴卫华[1] 陶虹[1] 郭丽丽[1] 仝丽[1] 武玮[1] 唐俊舫[1] MENG Qi-yi WU Wei-hua TAO Hong GUO Li-li TONG Li WU Wei TANG Jun-fang(Capital Medical University, Beijing Chest Hospital, Beijing Diagnosis and Treatment Center for Lung Cancer, Beijing 101149, China)

机构地区：[1]首都医科大学附属北京胸科医院肿瘤科,北京101149

出　　处：《中国医刊》2016年第10期94-97,共4页Chinese Journal of Medicine

摘　　要：目的：分析高龄广泛期小细胞肺癌的治疗与预后相关因素。方法选取1995年1月至2007年8月67例广泛期小细胞肺癌患者，年龄≥70岁。收集资料包括患者年龄、性别、体重、分期、ECOG评分、并发症、治疗前肝肾功能、血常规、乳酸脱氢酶（lactate dehydrogenase，LDH）水平、手术、放疗、一线化疗疗效、化疗周期、二线化疗的临床病例资料，应用单因素和多因素分析预后相关因素。结果67例患者中未做治疗18例（26.9%），49例（73.1%）进行了一线化疗。联合化疗以CE/EP方案为主，能够完成4周期以上化疗患者占32.6%（16/49），平均化疗周期2.92个。化疗有效率为53.1%（26/49），疾病控制率为72.1%（35/49）。8例患者接受二线治疗，9例接受放疗。患者MST为6.9个月（95%CI 5.667～11.100），1、2年生存率分别是26.0%、4%。单因素分析提示预后与疾病分期、ECOG评分、有无合并基础疾病、有无心血管系统疾病、治疗前LDH水平、有无治疗、手术、放疗、化疗疗效密切相关。全组Cox多因素分析显示生存与化疗周期数、一线化疗疗效有关。结论广泛期高龄小细胞肺癌一线化疗疗效部分缓解、化疗周期4个以上是生存独立预后因素。ObjectiveThe elderly comprise the major of patients with cancer. More than 30% of small cell lung cancer （SCLC） are over 70 years old. We set out to investigate several baseline patient and tumor characteristics and treatment method on overall survival separately for patients with extensive-disease small cell lung cancer（ED-SCLC）.Method Clinical data were collect from 67patients. All cases were diagnosis ED-SCLC by histopathology or cytology. We analyze the clinical factors that influenced survival time. The survival was analyzed by Kaplan-Meier and prognostic factors by COX multivariate regression.Result 18 cases were not received chemotherapy. 49 patients were evaluated in chemotherapy, 26 patients had PR disease（53.1%）, 14 patients had PD disease（28.6%）. The median survival time（MST） was 6.9 months（95%CI 5.667~11.100）.The 12-month, 24-month survival rates were 26.0% and 4%. Univariate analyses indicate that ECOG, complication, radiotherapy, efficacy of first-line chemotherapy, the cycle numbers of chemotherapy significantly influenced survival of ED-SCLC.Conclusion Efficacy of first-line chemotherapy and treatment cycles are independent prognostic factors of survival in ED stage small cell lung cancer patients older than 70 years.

关 键 词：小细胞肺癌 广泛期 高龄 预后 

分 类 号：R734.2[医药卫生—肿瘤]