中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2013年
9期
971-974
,共4页
非小细胞肺癌%放疗%化疗%预后
非小細胞肺癌%放療%化療%預後
비소세포폐암%방료%화료%예후
Non-small cell lung cancer%Radiotherapy%Chemotherapy%Prognosis
目的 探讨姑息性放疗对Ⅳ期非小细胞肺癌(NSCLC)患者预后的影响.方法 收集我院Ⅳ期NSCLC患者244例,其中129例(研究组)化疗后对原发灶及转移灶姑息性放疗,115例(对照组)单纯化疗,随访比较其1、2年生存率并探讨影响姑息性放疗效果的因素.结果 研究组患者随访2年16例生存,110例死亡,失访3例,中位生存时间为8个月,1、2年生存率分别为29.46％(38/129)、12.40％(16/129),对照组7例生存,106例死亡,2例失访,中位生存时间6个月,l、2年生存率分别为11.30％(13/115),6.09％(7/115),两组生存率比较差异有统计学意义(x2=8.451,P=0.014)；单因素分析发现,影响Ⅳ期NSCLC患者姑息性放疗预后的因素包括KPS评分(x2=5.057,P=0.031)、是否发生脑转移(x2 =4.781,P=0.029)、转移器官个数(x2=6.341,P=0.010)、原发灶放疗剂量(x2=5.893,P=0.015)；COX回归模型分析发现转移器官个数(HR=1.719,95％ CI为1.172 ～3.126,P=0.008)、原发灶放射剂量(HR=1.560,95％ CI为1.082 ～2.761,P=0.022)是影响预后的独立因素.结论 姑息性放射治疗在Ⅳ期NSCLC治疗中起到了延长生存期的作用.姑息性放疗需注意对原发灶及转移灶剂量的控制,从而延长患者生存时间.
目的 探討姑息性放療對Ⅳ期非小細胞肺癌(NSCLC)患者預後的影響.方法 收集我院Ⅳ期NSCLC患者244例,其中129例(研究組)化療後對原髮竈及轉移竈姑息性放療,115例(對照組)單純化療,隨訪比較其1、2年生存率併探討影響姑息性放療效果的因素.結果 研究組患者隨訪2年16例生存,110例死亡,失訪3例,中位生存時間為8箇月,1、2年生存率分彆為29.46％(38/129)、12.40％(16/129),對照組7例生存,106例死亡,2例失訪,中位生存時間6箇月,l、2年生存率分彆為11.30％(13/115),6.09％(7/115),兩組生存率比較差異有統計學意義(x2=8.451,P=0.014)；單因素分析髮現,影響Ⅳ期NSCLC患者姑息性放療預後的因素包括KPS評分(x2=5.057,P=0.031)、是否髮生腦轉移(x2 =4.781,P=0.029)、轉移器官箇數(x2=6.341,P=0.010)、原髮竈放療劑量(x2=5.893,P=0.015)；COX迴歸模型分析髮現轉移器官箇數(HR=1.719,95％ CI為1.172 ～3.126,P=0.008)、原髮竈放射劑量(HR=1.560,95％ CI為1.082 ～2.761,P=0.022)是影響預後的獨立因素.結論 姑息性放射治療在Ⅳ期NSCLC治療中起到瞭延長生存期的作用.姑息性放療需註意對原髮竈及轉移竈劑量的控製,從而延長患者生存時間.
목적 탐토고식성방료대Ⅳ기비소세포폐암(NSCLC)환자예후적영향.방법 수집아원Ⅳ기NSCLC환자244례,기중129례(연구조)화료후대원발조급전이조고식성방료,115례(대조조)단순화료,수방비교기1、2년생존솔병탐토영향고식성방료효과적인소.결과 연구조환자수방2년16례생존,110례사망,실방3례,중위생존시간위8개월,1、2년생존솔분별위29.46％(38/129)、12.40％(16/129),대조조7례생존,106례사망,2례실방,중위생존시간6개월,l、2년생존솔분별위11.30％(13/115),6.09％(7/115),량조생존솔비교차이유통계학의의(x2=8.451,P=0.014)；단인소분석발현,영향Ⅳ기NSCLC환자고식성방료예후적인소포괄KPS평분(x2=5.057,P=0.031)、시부발생뇌전이(x2 =4.781,P=0.029)、전이기관개수(x2=6.341,P=0.010)、원발조방료제량(x2=5.893,P=0.015)；COX회귀모형분석발현전이기관개수(HR=1.719,95％ CI위1.172 ～3.126,P=0.008)、원발조방사제량(HR=1.560,95％ CI위1.082 ～2.761,P=0.022)시영향예후적독립인소.결론 고식성방사치료재Ⅳ기NSCLC치료중기도료연장생존기적작용.고식성방료수주의대원발조급전이조제량적공제,종이연장환자생존시간.
Objective To investigate the impact of palliative radiotherapy to the prognosis of patients with stage Ⅳ non-small cell lung cancer (NSCLC).Methods Two hundred and forty-four cases of stage Ⅳ NSCLC were collected from our hospital.The study group (n =129) received the treatment of primary tumor and metastases palliative radiotherapy after chemotherapy.The control group (n =115) received only chemotherapy.Followed-up and compared 1-year and 2-year survival rate of the patients,and explored the factors affecting palliative radiotherapy.Results The 129 patients in the study group were followed up for 2 years,and 16 patients survived and 110 patients died.Three patients were lost to follow-up.The median survival time was 8 months.1-year and 2-year survival rates was 29.46％ (38/129) and 12.40％ (16/129) respectively.In the control group,7 patients survived,and 106 patients died.Two patients were lost to follow up.The median survival time was 6 months.1-year and 2-year survival rates was 11.30％ (13/115) and 6.09％ (7/115)respectively.Survival rates between the two groups were significantly different (x2 =8.451,P =0.014)Univariate regression analysis found that factors affecting the prognosis of stage Ⅳ NSCLC were KPS score (x2 =5.057,P =0.031),occurrence of brain metastases (x2 =4.781,P =0.029),number of organs of metastasis (x2 =6.341,P =0.010),and the primary stove radiotherapy dose (x2 =5.893,P =0.015) ; Cox regression model analysis showed that the number of organs of metastasis (HR =1.719,95％ CI 为 1.172-3.126,P =0.008),the primary focal radiotherapy dose (HR =1.560,95％ CI 为 1.082-2.761,P =0.022) were independent prognostic factors.Conclusion Palliative radiotherapy plays a role of prolonging survival time in the treatment of Ⅳ NSCLC.In palliative radiotherapy,we should pay attention to the control of the primary tumor and metastases radiotherapy dose,therefore prolonging the survival time of patients.
