转移性Ⅳ期非小细胞肺癌患者的生存状况及预后分析  

Survival and prognostic analysis of patients with metastatic stage Ⅳ NSCLC

作　　者：毕良文[1] 张丽珍[1] 赵滑峰[1] 王海静[1] 赵维勇[1] 姚志峰[1] 刘丽英 刘燕[1] Bi Liangwen;Zhang Lizhen;Zhao Huafeng;Wang Haijing;Zhao Weiyong;Yao Zhifeng;Liu Liying;Liu Yan(Department of Raidotherapy,The Second Affiliated Hospital of Nanjing Medical University,Nanjing 210011,China)

机构地区：[1]南京医科大学第二附属医院放疗科,江苏南京210011

出　　处：《实用肿瘤杂志》2018年第5期421-425,共5页Journal of Practical Oncology

摘　　要：目的探讨转移性Ⅳ期非小细胞肺癌患者生存状况、影响预后的相关因素以及寡转移与多发转移患者间的生存差异。方法回顾性分析90例转移性Ⅳ期非小细胞肺癌患者的临床资料,利用Kaplan-Meier法进行生存分析,并进行Log-rank检验,利用比例风险模型(Cox模型)进行多因素分析,筛选出相关因素。结果 90例转移性非小细胞肺癌患者1、2、3和5年总生存率分别为64.4%、21.1%、8.8%和1.1%,中位生存时间为14.5个月。寡转移和多发转移患者的1、2和3年生存率分别为89.4%、34.0%、17.0%和37.2%、6.9%、0%,中位生存时间分别为18个月和8个月,两者总生存率比较,差异具有统计学意义(χ2=27.104,P<0.01)。单因素分析结果显示,患者生存情况在KPS评分、组织学类型、转移状况、化疗周期数(≥4个或<4个)、原发病灶控制情况、靶向治疗及治疗模式方面比较,差异均具有统计学意义(均P<0.05)。多因素分析显示,KPS评分、原发灶已控、靶向治疗、寡转移和靶向治疗参与的治疗模式是预后的独立因素(均P<0.05)。结论 KPS≥70分、原发灶已控和寡转移的转移性非小细胞肺癌患者的生存期较长,是潜在的治疗获益患者。Objective To study the survival and prognostic factors of patients with metastatic stage Ⅳ non-smallcell lung cancer（ NSCLC） and the survival difference between oligometastatic and multiple metastatic patients. Methods The clinical data of 90 patients with metastatic stage Ⅳ NSCLC were retrospectively reviewed. Survival analysis was performed with Kaplan-Meier method and Log-rank test. Cox＇s proportion risk model was applied to complete multivariate analysis to identify related prognostic factors. Results Of 90 patients,the 1-year,2-year,3-year and 5-year overall survival rates were 64. 4%,21. 1%,8. 8% and 1. 1%,respectively,and the median survival time was 14. 5 months. Besides,the 1-year,2-year and 3-year overall survival rates were 89. 4%,34. 0% and 17. 0% in the oligometastatic patients,and 37. 2%,6. 9% and 0% in multiple metastatic patients,respectively. The median survival time was 18 months in the oligometastatic patients,and was 8 months in the multiple metastatic patients（ χ2= 27. 104,P 0. 01）. Univariate analysis showed that the survival was significantly diffferent in terms of KPS score,histological types,metastasis,chemotherapy cycles（ ≥4 vs 4）,primary tumor control,target therapy and therapy modes（ all P 0. 05）. Multivariate analysis indicated that KPS score,primary tumor control,target therapy,oligometastasis and therapy modes were independent prognostic factors（ all P 0. 05）. Conclusion Metastatic NSCLC patients with KPS score ≥70,controlled primary tumor and oligometastatic status tend to have longer survival time and may be benefited more from treatments.

关 键 词：癌 非小细胞肺 肿瘤转移 存活率 预后 比例危险度模型 回顾性研究 

分 类 号：R734.2[医药卫生—肿瘤]