Dujon C, Azarian R, Petitpretz P
Hôpital André Mignot, Service de Pneumologie, Le Chesnay, France.
Rev Mal Respir. 2009 Nov;26(9):952-60. doi: 10.1016/s0761-8425(09)73330-3.
The prognosis of non-small cell lung cancer (NSCLC) is poor, especially for advanced stages IIIB-IV. Clinical experience shows that the evolution of the disease is heterogeneous. A small number of patients survive more than 2 years after diagnosis; they are called long term survivors (LS). The aim of our study was to characterise this subgroup of patients.
A retrospective study in the respiratory department of a general hospital including all patients with a proven diagnosis of NSCLC stage IIIB and IV.
169 patients were included (43 females). There were 13.6% LS. Two thirds of the patients were PS 0-1, 84.6% were stage IIIBw-IV. Adenocarcinoma was the predominant histological type. Univariate analysis revealed that long term survival was associated with a Charlson's score < or = 2, PS 0-1, a normal white blood cell count at diagnosis, adenocarcinoma histology, response (RP) to first line treatment and treatment with a tyrosine-kinase inhibitor (TKI). In multivariate analysis only PS 0-1, RP and treatment with a TKI were independent factors for longer survival.
LS exist and represent 13.6% of our patients. TKI appear to offer new opportunities for these patients.
非小细胞肺癌(NSCLC)的预后较差,尤其是对于 IIIB-IV 期的晚期患者。临床经验表明,该疾病的进展具有异质性。少数患者在确诊后存活超过 2 年;他们被称为长期存活者(LS)。我们研究的目的是对这一亚组患者进行特征描述。
在一家综合医院的呼吸科进行一项回顾性研究,纳入所有确诊为 IIIB 期和 IV 期 NSCLC 的患者。
共纳入 169 例患者(43 例女性)。长期存活者占 13.6%。三分之二的患者体能状态(PS)为 0-1,84.6%为 IIIBw-IV 期。腺癌是主要的组织学类型。单因素分析显示,长期生存与查尔森评分≤2、PS 0-1、诊断时白细胞计数正常、腺癌组织学类型、对一线治疗的反应(RP)以及酪氨酸激酶抑制剂(TKI)治疗有关。多因素分析显示,只有 PS 0-1、RP 和 TKI 治疗是生存期延长的独立因素。
存在长期存活者,占我们患者的 13.6%。TKI 似乎为这些患者提供了新的机会。