老年小细胞肺癌患者预后分析  

Prognostic factor analysis of elderly patients with small-cell lung cancer

作　　者：尹一 黄章洲[1] 黄韵坚[1] 吴标[1] 庄武[1] Yin Yi;Huang Zhangzhou;Huang Yunjian;Wu Biao;Zhuang Wu(Department of Thoracic Medical Oncology,Fujian Cancer Hospital&Fujian Medical University Affiliated-Cancer Hospital,Fuzhou 350014,China)

机构地区：[1]福建省肿瘤医院福建医科大学附属肿瘤医院胸部肿瘤内科,福州350014

出　　处：《中华老年医学杂志》2019年第12期1357-1362,共6页Chinese Journal of Geriatrics

基　　金：国家临床重点专科建设项目(2013);福建省医学创新课题(2017-CXB-1)。

摘　　要：目的回顾性分析老年小细胞肺癌患者的临床资料,探讨预后影响因素。方法收集2006年1月至2017年2月我院初治年龄≥65岁的小细胞肺癌患者的临床资料,Kaplan-Meier法进行生存统计,Log rank检验进行单因素分析,对统计学阳性的单因素进行Cox法多因素分析。结果共143例患者,中位OS为17.9个月,局限期患者为21.3个月,广泛期为9.6个月。局限期患者,年龄(HR=18.688,95%CI:3.237~107.889)、吸烟指数(HR=2.783,95%CI:1.196~6.475)、胸部放疗(HR=0.305,95%CI:0.120~0.779)、化疗疗效(HR=0.210,95%CI:0.065~0.685)是影响预后的独立危险因素。广泛期患者化疗周期数(HR=0.461,95%CI:0.229~0.927)及体力状态评分(HR=0.422,95%CI:0.218~0.818)是影响独立的预后因素。结论吸烟指数、分期、治疗方式影响预后,局限期患者,年龄<75岁、吸烟指数<1000、接受胸部放疗、化疗缓解的患者预后更好,广泛期患者,体力状况评分好、足疗程的化疗有利于改善预后。Objective To retrospectively analyze clinical data of elderly patients with small-cell lung cancer(SCLC)in order to investigate their prognostic factors.Methods Clinical data of SCLC patients aged 65 years and over in our hospital from January 2006 to February 2017 were analyzed.Survival data were analyzed by Kaplan-Meier method.Univariate analysis of prognosis was conducted by Log rank test.Multivariate analysis was performed by Cox regression.Results A total of 143 patients were enrolled,the median overall survival(OS)was 17.9 months,with 21.3 months for limit stage(LD)and 9.6 months for extensive stage(ED).For LD patients,age(HR=18.688,95%CI:3.237-107.889),smoking index(HR=2.783,95%CI:1.196-6.475),thoracic irradiation(HR=0.305,95%CI:0.120-0.779),chemotherapy efficacy(HR=0.210,95%CI:0.065-0.685)were the independent risk factors for the prognosis.For ED patients,chemotherapy cycles(HR=0.461,95%CI:0.229-0.927)and performance status(HR=0.422,95%CI:0.218-0.818)were the independent risk factors for prognosis.Conclusions Smoking index,tumor stage and treatment mode can influence the survival of SCLC patients.The LD patients,who were aged less than 75 years,with smoking index less than 1000,receiving thoracic irradiation and achieving remission with chemotherapy,show a longer OS.For ED patients,a good performance status and sufficient chemotherapy can predict an improved OS.

关 键 词：小细胞肺癌 预后 

分 类 号：R73[医药卫生—肿瘤]