Jeremic Branislav, Milicic Biljana, Dagovic Aleksandar, Aleksandrovic Jasna, Nikolic Nebojsa
Department of Radiotherapy, Klinikum rechts der Isar, Technical University Munich, Ismaninger Strasse 22, 81675, Munich, Germany.
J Cancer Res Clin Oncol. 2003 Feb;129(2):114-22. doi: 10.1007/s00432-002-0408-4. Epub 2003 Mar 7.
We investigated the influence of potential pre-treatment clinical prognostic factors in stage IV non-small cell lung cancer (NSCLC).
A total of 285 patients were enrolled in two consecutive prospective randomised studies which compared (study 1) carboplatin and prolonged oral etoposide (group 1; n=58) with the same etoposide alone (group 2; n=59), and (study 2) carboplatin and prolonged oral etoposide (group 1; n=84) with the same carboplatin and high-dose intravenous etoposide (group 2; n=84).
The median survival time for all 285 patients was 7 months, while 1- and 2-year survival rates were 29% and 8%, respectively. Age did not impact on outcome ( P=0.21), while female patients did significantly better than male patients ( P<0.0001). Patients with KPS 80-100 did significantly better than those with KPS 50-70 ( P<0.0001), as did patients with less pronounced weight loss ( P<0.0001) and those with only one metastatic site when compared to those having at least two metastatic sites ( P<0.0001). When evaluated regarding the metastatic site, only subcutaneous metastatic site did not influence survival. This was confirmed within univariate analyses, but when multivariate analyses were done gender, KPS, weight loss, number of metastatic sites, presence of liver metastases and presence of brain metastases independently influenced survival, while age and other metastatic locations did not.
In this analysis, gender, KPS, weight loss, number of metastatic sites, presence of liver metastases and presence of brain metastases independently influenced survival in patients with stage IV NSCLC treated with CHT.
我们研究了潜在的预处理临床预后因素对IV期非小细胞肺癌（NSCLC）的影响。
共有285例患者纳入两项连续的前瞻性随机研究，这两项研究比较了（研究1）卡铂与延长口服依托泊苷（第1组；n = 58）与单独使用相同的依托泊苷（第2组；n = 59），以及（研究2）卡铂与延长口服依托泊苷（第1组；n = 84）与相同的卡铂和高剂量静脉注射依托泊苷（第2组；n = 84）。
所有285例患者的中位生存时间为7个月，1年和2年生存率分别为29%和8%。年龄对预后无影响（P = 0.21），而女性患者的预后明显优于男性患者（P < 0.0001）。KPS 80 - 100的患者比KPS 50 - 70的患者预后明显更好（P < 0.0001），体重减轻不明显的患者也是如此（P < 0.0001），与有至少两个转移部位的患者相比，只有一个转移部位的患者预后更好（P < 0.0001）。当评估转移部位时，只有皮下转移部位不影响生存。这在单因素分析中得到证实，但在多因素分析中，性别、KPS、体重减轻、转移部位数量、肝转移的存在和脑转移的存在独立影响生存，而年龄和其他转移部位则没有。
在本分析中，性别、KPS、体重减轻、转移部位数量、肝转移的存在和脑转移的存在独立影响接受化疗的IV期NSCLC患者的生存。
