中国肺癌杂志
中國肺癌雜誌
중국폐암잡지
CHINESE JOURNAL OF LUNG CANCER
2014年
1期
15-23
,共9页
陈筱玲%方健%聂鋆%戴玲%张洁%胡维亨%韩金娣%马向娟%田广明%韩森%吴頔%龙皆然%王洋
陳篠玲%方健%聶鋆%戴玲%張潔%鬍維亨%韓金娣%馬嚮娟%田廣明%韓森%吳頔%龍皆然%王洋
진소령%방건%섭윤%대령%장길%호유형%한금제%마향연%전엄명%한삼%오적%룡개연%왕양
肺肿瘤%老年医学%生存期%预后
肺腫瘤%老年醫學%生存期%預後
폐종류%노년의학%생존기%예후
Lung neoplsms%Geriatrics%Survival%Prognosis
背景与目的肺癌是目前恶性肿瘤死亡的首要原因，2/3的患者年龄超过65岁，小细胞肺癌约占全部肺癌15%-20%。本研究旨在分析65岁以上老年小细胞肺癌患者的生存状况及预后因素。方法回顾性研究160例65岁以上老年小细胞肺癌患者临床资料，采用Kaplan-Meier法及Cox多因素回归分析预后因素。结果①中位随访12个月（2个月-109个月）。全组1年、3年、5年生存率分别为47.1%、13.0%、9.6%，局限期为74.4%、25.0%、19.7%，广泛期为36.8%、8.7%、5.8%。全组中位生存期（median survival time, MST）12个月，局限期24个月、广泛期11个月。全组的中位无进展生存期（progression-free survival, PFS）6个月，局限期10个月、广泛期5个月。②全组分析提示治疗前体能状态（performance status, PS）评分、治疗后PS改变、分期、有无肝转移、胸部放疗是独立预后因素。③局限期中，治疗前PS评分、胸部放疗是独立预后因素。胸部放疗方式（同步放化疗vs序贯放疗、早期同步放化疗vs晚期同步放化疗）及是否行预防性全脑放疗，MST均未见统计学差异。④广泛期中性别、治疗后PS改变、化疗方案、有无肝转移、胸部放疗、预防性全脑放疗是独立预后因素。结论老年小细胞肺癌患者生存期与PS评分和胸部放疗相关，而广泛期患者还与性别、化疗方案、有无肝转移及是否行预防性全脑放疗相关。
揹景與目的肺癌是目前噁性腫瘤死亡的首要原因，2/3的患者年齡超過65歲，小細胞肺癌約佔全部肺癌15%-20%。本研究旨在分析65歲以上老年小細胞肺癌患者的生存狀況及預後因素。方法迴顧性研究160例65歲以上老年小細胞肺癌患者臨床資料，採用Kaplan-Meier法及Cox多因素迴歸分析預後因素。結果①中位隨訪12箇月（2箇月-109箇月）。全組1年、3年、5年生存率分彆為47.1%、13.0%、9.6%，跼限期為74.4%、25.0%、19.7%，廣汎期為36.8%、8.7%、5.8%。全組中位生存期（median survival time, MST）12箇月，跼限期24箇月、廣汎期11箇月。全組的中位無進展生存期（progression-free survival, PFS）6箇月，跼限期10箇月、廣汎期5箇月。②全組分析提示治療前體能狀態（performance status, PS）評分、治療後PS改變、分期、有無肝轉移、胸部放療是獨立預後因素。③跼限期中，治療前PS評分、胸部放療是獨立預後因素。胸部放療方式（同步放化療vs序貫放療、早期同步放化療vs晚期同步放化療）及是否行預防性全腦放療，MST均未見統計學差異。④廣汎期中性彆、治療後PS改變、化療方案、有無肝轉移、胸部放療、預防性全腦放療是獨立預後因素。結論老年小細胞肺癌患者生存期與PS評分和胸部放療相關，而廣汎期患者還與性彆、化療方案、有無肝轉移及是否行預防性全腦放療相關。
배경여목적폐암시목전악성종류사망적수요원인，2/3적환자년령초과65세，소세포폐암약점전부폐암15%-20%。본연구지재분석65세이상노년소세포폐암환자적생존상황급예후인소。방법회고성연구160례65세이상노년소세포폐암환자림상자료，채용Kaplan-Meier법급Cox다인소회귀분석예후인소。결과①중위수방12개월（2개월-109개월）。전조1년、3년、5년생존솔분별위47.1%、13.0%、9.6%，국한기위74.4%、25.0%、19.7%，엄범기위36.8%、8.7%、5.8%。전조중위생존기（median survival time, MST）12개월，국한기24개월、엄범기11개월。전조적중위무진전생존기（progression-free survival, PFS）6개월，국한기10개월、엄범기5개월。②전조분석제시치료전체능상태（performance status, PS）평분、치료후PS개변、분기、유무간전이、흉부방료시독립예후인소。③국한기중，치료전PS평분、흉부방료시독립예후인소。흉부방료방식（동보방화료vs서관방료、조기동보방화료vs만기동보방화료）급시부행예방성전뇌방료，MST균미견통계학차이。④엄범기중성별、치료후PS개변、화료방안、유무간전이、흉부방료、예방성전뇌방료시독립예후인소。결론노년소세포폐암환자생존기여PS평분화흉부방료상관，이엄범기환자환여성별、화료방안、유무간전이급시부행예방성전뇌방료상관。
Background and objective Lung cancer is currently the leading cause of cancer death, two thirds of patients are over the age of 65. Small cell lung cancer (SCLC) accounts for about15%-20%of all lung cancer. hTe objective of this study is to evaluate the survival of patients older than 65 with SCLC and analyze the independent prognostic factors in this group of patients. Methods A retrospective study has enrolled160 cases of lung cancer aged over 65. hTe prognostic factors were analyzed by Kaplan-Meier and Cox multivariate proportional hazards model. Results ①hTe median follow-up time was12 (2-109) months.1-, 3-, and 5-year survival rate was 47.1%,13.0%, 9.6%respectively, and 74.4%, 25.0%,19.7%for limited-stage (LD), and 36.8%, 8.7%, 5.8%for extensive-stage (ED). Median survival time (MST) of all the patients was12 months, 24 months for LD and11months for ED, respectively.②Multivariate analysis suggested that performance status (PS) pre-treatment, the change of PS atfer treatment, stage, liver metastases and thoracic radiotherapy were the independent prognostic factors in all patients.③For LD-SCLC patients, PS pre-treatment, thoracic radiotherapy were the independent prognostic fac-tors. hTe model of thoracic radiotherapy (concurrent chemoradiation vs sequential chemoradiation, early concurrent chemo-radiation vs late concurrent chemoradiation) and prophylactic cranial irradiation (PCI) did not show signiifcant difference.④For ED-SCLC patients, sex, the change of PS atfer treatment, chemotherapy, liver metastases, thoracic radiotherapy, PCI were the independent prognostic factors. Conclusion hTe survival time is related to PS and thoracic radiotherapy in eldly patients. Besides, it is also related to sex, chemotherapy, liver metastases and PCI for ED-SCLC.
