Laohavinij Sudsawat, Maneechavakajorn Jedzada
Department of Medicine, Rajavithi Hospital, Thailand.
J Med Assoc Thai. 2004 Sep;87(9):1056-64.
To determine the prognostic value for survival of various pretreatment characteristics and treatments in advanced non-small cell lung cancer (NSCLC) patients.
The retrospective study was conducted by reviewing the 81 files of advanced NSCLC patients treated with chemotherapy at the Oncology Unit, Rajavithi Hospital. Eighteen clinical variables were investigated and analysed as prognostic factors for survival.
The first chemotherapy regimens for the 81 patients included: etoposide plus platinum derivatives (41), new drugs (taxanes or gemcitabine) plus platinum derivatives (39) and one other platinum based regimen (1). The overall survival time for all patients was 39.4 weeks with a 95% confidence interval of 30 to 49 weeks. In the multivariate analysis, male gender; bone metastasis and liver metastasis are poor prognostic factors. Receiving palliative surgery and achieving objective response to first regimen chemotherapy are good prognostic factors. Patients who received either old or new drug combinations showed no difference in their survival as determined by univariate or multivariate analyses which could be due to limitations in the present retrospective study. However; this may show that regimens consisting of older, less expensive drug combinations still provide survival advantages in advanced NSCLC and should be considered in limited financial circumstances.
确定晚期非小细胞肺癌（NSCLC）患者各种治疗前特征及治疗方法对生存的预后价值。
通过回顾拉贾维提医院肿瘤科接受化疗的81例晚期NSCLC患者的病历进行回顾性研究。调查并分析了18项临床变量作为生存的预后因素。
81例患者的初始化疗方案包括：依托泊苷加铂类衍生物（41例）、新药（紫杉烷类或吉西他滨）加铂类衍生物（39例）以及另一种铂类方案（1例）。所有患者的总生存时间为39.4周，95%置信区间为30至49周。在多因素分析中，男性、骨转移和肝转移是不良预后因素。接受姑息性手术以及对初始方案化疗取得客观反应是良好的预后因素。接受旧药或新药联合治疗的患者在单因素或多因素分析中生存情况无差异，这可能是由于本回顾性研究存在局限性。然而，这可能表明由较老、较便宜的药物联合组成的方案在晚期NSCLC中仍具有生存优势，在资金有限的情况下应予以考虑。
