CAJ | 학술논문

目的：研究吉非替尼有效的非小细胞肺癌患者，骨转移是否影响其生存期，并分析骨转移患者的预后因素。方法比较骨转移和无骨转移患者总生存、无进展生存、1年、2年及3年生存率，并分析影响骨转移患者预后的因素。结果无骨转移组44例，骨转移组32例。无骨转移组与有骨转移组总生存期（19．000±3．317月 vs．26．000±2．121月，P＝0．625）和无进展生存期（14．000±1．843月 vs．16．000±1．411月，P＝0．328）无统计学差异。前组患者1年生存率63．6％低于后者96．9％，2年和3年生存率分别为（34．1％vs．56．3％，P＝0．054）和（18．2％vs．18．4％，P＝0．950），无统计学差异。对骨转移组进行单因素分析显示年龄＞60岁及有肺内进展者预后更差，多因素分析显示影响骨转移患者生存的有效因素为有肺内进展，而性别、病理、吸烟指数、是否合并脑转移、骨相关事件及是否应用放疗、双膦酸盐与骨转移患者中位生存时间均无明显相关性。结论吉非替尼治疗有效的非小细胞肺癌患者，骨转移可能不是影响其生存期的主要因素，肺内进展有可能是非小细胞肺癌骨转移者的主要死因，不能将骨转移作为停用吉非替尼的指征。
목적：연구길비체니유효적비소세포폐암환자，골전이시부영향기생존기，병분석골전이환자적예후인소。방법비교골전이화무골전이환자총생존、무진전생존、1년、2년급3년생존솔，병분석영향골전이환자예후적인소。결과무골전이조44례，골전이조32례。무골전이조여유골전이조총생존기（19．000±3．317월 vs．26．000±2．121월，P＝0．625）화무진전생존기（14．000±1．843월 vs．16．000±1．411월，P＝0．328）무통계학차이。전조환자1년생존솔63．6％저우후자96．9％，2년화3년생존솔분별위（34．1％vs．56．3％，P＝0．054）화（18．2％vs．18．4％，P＝0．950），무통계학차이。대골전이조진행단인소분석현시년령＞60세급유폐내진전자예후경차，다인소분석현시영향골전이환자생존적유효인소위유폐내진전，이성별、병리、흡연지수、시부합병뇌전이、골상관사건급시부응용방료、쌍련산염여골전이환자중위생존시간균무명현상관성。결론길비체니치료유효적비소세포폐암환자，골전이가능불시영향기생존기적주요인소，폐내진전유가능시비소세포폐암골전이자적주요사인，불능장골전이작위정용길비체니적지정。
Obj ectiev The purpose of this study is to assess the impact of bone metastasis on survival in non-small cell lung cancer(NSCLC),Which were treated with gefitinib for more than 6 months,and to identify the prognostic factors of patients with NSCLC presenting bone metastasis .Methods We compared the overall survival(OS), progression-free survival(PFS),1-year2,-year and 3-year survival rates between two cohorts based on bone metastasis ,as well as the prognostic factors in the patients with bone metastasis .Results In total, 76 patients were included in the study ,in which there are44 patients with no bone metastasis and32 patients with bone metastasis.The cohorts were similar in OS (19.000 ±3.317 months vs.26.000 ±2.121 months,P =0.625)as well as PFS (14.000 ±1.843 months vs.16.000 ±1.411 months,P=0.328).The 1-year survival rate was 63.6%in no bone metastasis cohort,but was increased to 96.9%in the other cohort.The survival rates at 2 years(34.1%vs.56.3%,P=0.054)and 3 years(18.2%vs.18.4%,P=0.950)were similar.The univa-riate analysis showed that a worse prognosis was more likely existed in elderly patients ( aged >60 years) and with pulmonary progression ,whereby factors including gender ,pathology s,moking index ,brain metastases ,bone related events and the application of radiotherapy ,bisphosphonates might not be independently associated with the surviv -al late.Analysis of multiple variables indicated a favorable prognosis for patients with no pulmonary progression . Conclusion This retrospective study shows that bone metastasis may not shorten the survival in patients whose pulmonary lesion was controlled by gefitinib .On the contrary ,pulmonary progression may be more likely the cause of death in patients with bone metastasis .Non suggestion is given to discontinue gefitinib when the bone metastasis appears.