Shinkai T, Eguchi K, Sasaki Y, Tamura T, Ohe Y, Kojima A, Oshita F, Miya T, Okamoto H, Iemura K
Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.
Cancer Chemother Pharmacol. 1992;30(1):1-6. doi: 10.1007/BF00686477.
Prognostic factors for response and survival were retrospectively evaluated in 192 previously untreated patients with advanced non-small-cell lung cancer (NSCLC) who had received either vindesine plus cisplatin or mitomycin plus vindesine plus cisplatin as initial treatment. Univariate analysis demonstrated that squamous-cell histology, early stage, and a small number of metastatic sites were favorable prognostic factors for response to chemotherapy. Multivariate analysis using Cox's proportional hazard model indicated that the number of metastatic sites was the only significant pretreatment factor for response (P = 0.0005). Multivariate regression analysis revealed that the number of metastatic sites (P = 0.0002), sex (P = 0.0009), serum albumen levels (P = 0.0018), performance status (P = 0.0026) and lactic dehydrogenase values (P = 0.0026) contributed independently to survival. On the basis of these five prognostic factors, a prognostic index for survival was used to define three prognostic groupings (good, intermediate, and poor) for survival (median survival, 16.5 vs 9.4 vs 4.6 months; P = 0.0001). This particular regression model should aid in the design and analysis of new treatment strategies and may be useful for indirect comparisons of different studies carried out in similar patient populations.
对192例先前未接受过治疗的晚期非小细胞肺癌（NSCLC）患者进行回顾性评估，这些患者初始治疗接受了长春地辛加顺铂或丝裂霉素加长春地辛加顺铂。单因素分析表明，鳞状细胞组织学、早期阶段和转移部位数量少是化疗反应的有利预后因素。使用Cox比例风险模型的多因素分析表明，转移部位数量是反应的唯一显著预处理因素（P = 0.0005）。多因素回归分析显示，转移部位数量（P = 0.0002）、性别（P = 0.0009）、血清白蛋白水平（P = 0.0018）、体能状态（P = 0.0026）和乳酸脱氢酶值（P = 0.0026）独立影响生存。基于这五个预后因素，使用生存预后指数定义了三个生存预后分组（良好、中等和不良）（中位生存期，16.5对9.4对4.6个月；P = 0.0001）。这种特定的回归模型应有助于新治疗策略的设计和分析，可能有助于对相似患者群体中进行的不同研究进行间接比较。
