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[影响晚期非小细胞肺癌患者接受联合化疗后生存及反应的预后因素]

[Prognostic factors affecting survival and response in patients with advanced non-small cell lung cancer treated with combination chemotherapy].

作者信息

Takifuji N, Fukuoka M, Negoro S, Takada M, Kusunoki Y, Matsui K, Masuda N, Ryu S, Sakai N, Kubota K

机构信息

Dept. of Internal Medicine, Osaka Prefectural Habikino Hospital.

出版信息

Gan To Kagaku Ryoho. 1990 Mar;17(3 Pt 2):429-34.

PMID:2157364
Abstract

One-hundred and ninety-nine patients who had an inoperable stage III or IV non-small cell lung cancer (NSCLC) and collected were analyzed on the basis of factors affecting survival duration and response to chemotherapy. These patients were registered into a prospective randomized trial conducted from May of 1986 to April of 1988, and received either cisplatin and vindesine, cisplatin, vindesine and mitomycin C, or cisplatin and etoposide alternating with vindesine and mitomycin C. In the univariate analysis, sex, ECOG's performance status (PS), weight loss within previous 6 months, clinical stage, serum albumin value, serum lactate dehydrogenase level and hemoglobin (Hb) level were considered to be significant factors for survival (p less than 0.05). In the multivariable analysis using Cox's proportional model, clinical stage, PS, sex, weight loss and Hb level were proven to be significant variables for survival in the order of importance. When the response to chemotherapy was included in a conditional multivariable analysis, it was strongly associated with survival duration. A multivariable analysis of response using the logistic regression method demonstrated that female sex, cisplatin, vindesine and mitomycin combination regimen, squamous cell type, and no weight loss were significantly predictive of response outcome. These results are useful when comparing the response data and survival of completed studies and designing future trials in advanced NSCLC.

摘要

对收集到的199例患有无法手术的III期或IV期非小细胞肺癌(NSCLC)患者,根据影响生存时间和化疗反应的因素进行分析。这些患者被纳入了一项于1986年5月至1988年4月进行的前瞻性随机试验,接受顺铂和长春地辛、顺铂、长春地辛和丝裂霉素C,或顺铂和依托泊苷交替联合长春地辛和丝裂霉素C治疗。在单因素分析中,性别、东部肿瘤协作组(ECOG)的体能状态(PS)、前6个月内的体重减轻、临床分期、血清白蛋白值、血清乳酸脱氢酶水平和血红蛋白(Hb)水平被认为是生存的显著因素(p<0.05)。在使用Cox比例模型的多变量分析中,临床分期、PS、性别、体重减轻和Hb水平按重要性顺序被证明是生存的显著变量。当在条件多变量分析中纳入化疗反应时,其与生存时间密切相关。使用逻辑回归方法对反应进行的多变量分析表明,女性、顺铂、长春地辛和丝裂霉素联合方案、鳞状细胞类型以及无体重减轻对反应结果具有显著预测性。这些结果在比较已完成研究的反应数据和生存情况以及设计未来晚期NSCLC试验时很有用。

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