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老年晚期非小细胞肺癌患者化疗的预后因素

Prognostic factors in elderly patients with advanced non-small cell lung cancer treated with chemotherapy.

作者信息

Li Jian, Chen Ping, Dai Chun-Hua, Li Xiao-Qin, Bao Quan-Lei

机构信息

Department of Pulmonary Medicine, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, China.

出版信息

Oncology. 2009;76(5):355-62. doi: 10.1159/000210024. Epub 2009 Mar 25.

Abstract

OBJECTIVE

The prognosis of advanced non-small cell lung cancer (NSCLC) is poor. The aim of this study was to assess the outcome of chemotherapy for elderly patients with advanced NSCLC, focusing on the prognostic factors influencing survival.

METHODS

We reviewed retrospectively the medical records of 109 elderly patients with advanced NSCLC treated with chemotherapy from January 1999 to December 2006. Collected data included demographic information, clinical assessment before therapy, and information on treatment and outcome. Survival was estimated using the Kaplan-Meier method, and prognostic factors were analyzed by the log-rank test and Cox regression model.

RESULTS

The median survival time for the entire group was 10.5 (95% confidence interval: 9.15-11.88) months, with 1- and 2-year survival rates of 31.2 and 9.2%, respectively. Univariate analysis showed that performance status (PS; p = 0.013), comorbidity (p = 0.006), chemotherapy cycle (p = 0.006) and second-line therapy (p = 0.002) significantly influenced overall survival. In multivariate analysis, comorbidity, chemotherapy cycles and second-line therapy were identified as independent prognostic factors.

CONCLUSIONS

Survival of elderly patients with advanced NSCLC treated with chemotherapy is significantly influenced by the patient's PS, comorbidity, chemotherapy cycle and second-line therapy. These results may help to choose the appropriate treatment in clinical practice.

摘要

目的

晚期非小细胞肺癌(NSCLC)的预后较差。本研究旨在评估老年晚期NSCLC患者化疗的疗效,重点关注影响生存的预后因素。

方法

我们回顾性分析了1999年1月至2006年12月期间接受化疗的109例老年晚期NSCLC患者的病历。收集的数据包括人口统计学信息、治疗前的临床评估以及治疗和结局信息。采用Kaplan-Meier法估计生存率,并通过对数秩检验和Cox回归模型分析预后因素。

结果

整个组的中位生存时间为10.5(95%置信区间:9.15 - 11.88)个月,1年和2年生存率分别为31.2%和9.2%。单因素分析显示,体能状态(PS;p = 0.013)、合并症(p = 0.006)、化疗周期(p = 0.006)和二线治疗(p = 0.002)对总生存有显著影响。多因素分析中,合并症、化疗周期和二线治疗被确定为独立的预后因素。

结论

接受化疗的老年晚期NSCLC患者的生存受患者的PS、合并症、化疗周期和二线治疗的显著影响。这些结果可能有助于在临床实践中选择合适的治疗方法。

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