化疗同期三维放疗对Ⅳ期非小细胞肺癌的治疗效果及患者生存状态的影响因素分析  

Analysis of the therapeutic effect of chemotherapy concurrently with three-dimensional radiotherapy on stageⅣnon-small cell lung cancer and the influencing factors of patients′survival status

作　　者：胡海峰[1] 谢圆媛[2] 年亮 段伟[1] 刘宁宁[1] HU Haifeng;XIE Yuanyuan;NIAN Liang;DUAN Wei;LIU Ningning(Department of Oncology,Yan′an University Affiliated Hospital,Yan′an,Shaanxi 716000,China;Department of Geriatrics,Yan′an University Affiliated Hospital,Yan′an,Shaanxi 716000,China)

机构地区：[1]延安大学附属医院肿瘤科,陕西延安716000 [2]延安大学附属医院老年病科,陕西延安716000

出　　处：《检验医学与临床》2022年第16期2173-2176,共4页Laboratory Medicine and Clinic

基　　金：陕西省教育厅专项科研计划项目(16JK2031)。

摘　　要：目的分析化疗同期三维放疗对Ⅳ期非小细胞肺癌(NSCLC)的治疗效果,并探讨患者生存状态的影响因素。方法选取该院2014年1月至2016年2月收治的107例采用化疗同期三维放疗的Ⅳ期NSCLC患者作为研究对象。统计患者5年内生存情况,计算累积生存率及中位生存时间(MST)。评估患者的近期临床疗效。于治疗前和完成2个周期治疗后1周内对患者进行卡氏功能状态(KPS)评分,评估其生存状态。观察患者治疗期间的不良反应。分析患者治疗后生存状态的影响因素。结果107例Ⅳ期NSCLC患者1、2、3、5年生存率分别为59.81%、21.50%、12.15%和7.48%,MST为17.5个月。化疗同期三维放疗4~6个周期后,完全缓解有24例(22.43%),部分缓解有57例(53.27%),总有效率为75.70%。治疗前KPS评分为(62.73±4.85)分,完成2个周期治疗后KPS评分为(74.39±4.91)分,治疗前后比较,差异有统计学意义(t=17.476,P<0.001)。治疗期间患者不良反应总发生率为35.51%。多因素Cox回归分析结果显示,病理分型、癌细胞转移状态、原发灶控制情况、近期疗效是Ⅳ期NSCLC患者治疗后生存状态的独立影响因素(P<0.05)。结论化疗同期三维放疗能够显著改善Ⅳ期NSCLC患者预后,同时病理分型、癌细胞转移状态、原发灶控制情况、近期疗效可影响Ⅳ期NSCLC患者治疗后的生存状态,临床应予以高度重视。Objective To analyze the therapeutic effect of chemotherapy concurrently with three-dimensional radiotherapy on stageⅣnon-small cell lung cancer(NSCLC),and to explore the influencing factors of patients′survival status.Methods A total of 107 patients with stageⅣNSCLC who were treated with chemotherapy concurrently with three-dimensional radiotherapy from January 2014 to February 2016 in the hospital were selected as the research subjects.The 5-year survival status of the patients was counted,and the cumulative survival rate and median survival time(MST)were calculated.Evaluated the short-term clinical curative effect of patients.KPS scores were performed on patients before treatment and within 1 week after completing 2 cycles of treatment to evaluate their survival status.Observed the adverse reactions of patients during treatment.The influencing factors of patients′survival status after treatment were analyzed.Results The 1,2,3 and 5-year survival rates of 107 patients with stageⅣNSCLC were 59.81%,21.50%,12.15%and 7.48%respectively,and the MST was 17.5 months.After 4—6 cycles of chemotherapy concurrently with three-dimensional radiotherapy,24 cases(22.43%)had complete remission and 57 cases(53.27%)had partial remission,with the total effective rate of 75.70%.The KPS score before treatment was(62.73±4.85)points,and the KPS score after 2 cycles of treatment was(74.39±4.91)points,and the difference was statistically significant before and after treatment(t=17.476,P<0.001).The total incidence of adverse reactions in patients during treatment was 35.51%.The results of multivariate Cox regression analysis showed that pathological type,cancer cell metastasis status,primary tumor control,and short-term curative effect were independent influencing factors of survival status of patients with stageⅣNSCLC after treatment(P<0.05).Conclusion Chemotherapy concurrently with three-dimensional radiotherapy can significantly improve the prognosis of patients with stageⅣNSCLC.At the same time,pathological type,can

关 键 词：非小细胞肺癌 化疗 三维放疗 生存状态 

分 类 号：R734.2[医药卫生—肿瘤]