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[晚期非小细胞肺癌长期生存者:一项回顾性研究中的特征与预后因素]

[Long-term survivors of advanced non-small-cell lung cancer: characterisation and prognostic factors in a retrospective study].

作者信息

Dujon C, Azarian R, Petitpretz P

机构信息

Hôpital André Mignot, Service de Pneumologie, Le Chesnay, France.

出版信息

Rev Mal Respir. 2009 Nov;26(9):952-60. doi: 10.1016/s0761-8425(09)73330-3.

Abstract

INTRODUCTION

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.

METHODS

A retrospective study in the respiratory department of a general hospital including all patients with a proven diagnosis of NSCLC stage IIIB and IV.

RESULTS

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.

CONCLUSION

LS exist and represent 13.6% of our patients. TKI appear to offer new opportunities for these patients.

摘要

引言

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。

方法

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。

结果

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。

结论

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。

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