Risteski Milan, Crvenkova Simonida, Atanasov Zoran, Isjanovska Rozalinda
Department of Lung Cancer at UCRO, Skopje, R. Macedonia.
Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2013;34(3):49-61.
Lung cancer represents the leading cause of cancer mortality worldwide, accounting for ~1.2 million deaths each year. Improving survival in lung cancer is a major challenge for modern oncology considering that 5-year survival remains < 15%, across all stages of the disease with < 7% of patients alive 10 years after diagnosis. About 85% to 90% of lung cancers are non-small-cell lung cancer (NSCLC). Lung cancer is the leading cause of cancer-related mortality in Macedonia with more than 900 newly diagnosed lung cancer patients per year. The motive for undertaking the study was precisely the lack of adequate statistical data on treatment outcomes and survival rates of non-smal-cell lung cancer patients in the country. The main goal was to provide an assessment of progression-free survival and overall survival in NSCLC patients treated at UCRO-Skopje, over the past three years: 2009-2011. The research represents a follow-up study. The study was based on filling in forms for an epidemiological analysis of PFS and OS in NSCLC patients. These forms contain demographic, clinical and histological data, as well as dates of diagnosis, treatment initiation and outcomes. Data were collected from patient files for a period of three years (2009-2011), collected through the registration of each NSCLC patient treated in the period of the investigation. The statistical series were analysed by determining the ratio, proportions, chi-square and Student t-test and survival analysis. The study included 1002 patients with NSCLC treated at the UCRO, of whom 859 were males and 137 were females, and 0.6% missing data for gender. The average age of patients was 60.4 ± 9.0 y., min. of 19 y., max. of 85 y. Most of the patients were smokers- 86.9%. The dominant stage in NSCLC was stage IV, with 36.3%, followed by IIIA 17.5%, stages IIIB and IIB with 13.6% and so on. In the examined group of patients the most common subtype was 56.9% with planocellular, 28.2% with adenocarcinoma, large-cell with 7.7% and missing / no closer subtype 7.2%. Median survival from diagnosis to the last check-up/death was 6.2 m. 25% of patients with NSCLC from diagnosis to the last check-up/death died in the first 2.5 m and 25% survived more than 11.1 m. Median survival from treatment outset to the last check-up/death was 5.4 m. 25% of patients with NSCLC survived for two months from the outset of treatment to the last check-up/death and 25% survived for more than 10.8 m. In the course of the study we found that the median survival in 2009, 2010 and 2011 differed from the diagnosis to the last control/death. In 2009, median survival was 7.5 m and we registered a statistically significantly longer survival compared to 2010 - 6.1 m, and 2011 - 5.4 m. Similar data and conclusions were received in calculating the survival from therapy to the last check-up/death. Median survival in 2009 was 6.2 m and this is a statistically significant longer survival compared with 2010 (5.9 m) and 2011 (4.6 m). The results indicate that compared with international data patients with NSCLC had a shorter life of survival.We hope that this study will help to improve the future treatment of non-small-cell lung cancer patients through optimizing the treatment for every single patient, which will help in longer patient survival. Precise determination of these data provides for a proper selection of the best treatment option and optimized therapy for every patient.
肺癌是全球癌症死亡的主要原因，每年约有120万人死亡。鉴于肺癌各阶段的5年生存率仍低于15%，诊断后10年仍存活的患者不到7%，提高肺癌患者的生存率是现代肿瘤学面临的一项重大挑战。约85%至90%的肺癌为非小细胞肺癌（NSCLC）。肺癌是马其顿癌症相关死亡的主要原因，每年有超过900例新诊断的肺癌患者。开展这项研究的动机正是该国缺乏关于非小细胞肺癌患者治疗结果和生存率的充分统计数据。主要目标是评估2009 - 2011年过去三年在斯科普里大学肿瘤研究所（UCRO）接受治疗的NSCLC患者的无进展生存期和总生存期。该研究是一项随访研究。该研究基于填写NSCLC患者PFS和OS的流行病学分析表格。这些表格包含人口统计学、临床和组织学数据，以及诊断日期、治疗开始日期和结果。数据是从三年（2009 - 2011年）期间的患者档案中收集的，通过对研究期间接受治疗的每位NSCLC患者进行登记来收集。通过确定比率、比例、卡方检验和学生t检验以及生存分析对统计系列进行分析。该研究纳入了1002例在UCRO接受治疗的NSCLC患者，其中859例为男性，137例为女性，性别数据缺失率为0.6%。患者的平均年龄为60.4±9.0岁，最小19岁，最大85岁。大多数患者为吸烟者，占86.9%。NSCLC中占主导地位的阶段是IV期，占36.3%，其次是IIIA期，占17.5%，IIIB期和IIB期各占13.6%等等。在所检查的患者组中，最常见的亚型是鳞状细胞癌，占56.9%，腺癌占28.2%，大细胞癌占7.7%，缺失/无更明确亚型占7.2%。从诊断到最后一次检查/死亡的中位生存期为6.2个月。25%的NSCLC患者从诊断到最后一次检查/死亡在最初2.5个月内死亡，25%存活超过11.1个月。从治疗开始到最后一次检查/死亡的中位生存期为5.4个月。25%的NSCLC患者从治疗开始到最后一次检查/死亡存活了两个月，25%存活超过10.8个月。在研究过程中，我们发现2009年、2010年和2011年从诊断到最后一次对照/死亡的中位生存期有所不同。2009年，中位生存期为7.5个月，与2010年的6.1个月和2011年的5.4个月相比，我们记录到生存期在统计学上显著更长。在计算从治疗到最后一次检查/死亡的生存期时也得到了类似的数据和结论。2009年的中位生存期为6.2个月，与2010年（5.9个月）和2011年（4.6个月）相比，这在统计学上显著更长。结果表明，与国际数据相比，NSCLC患者的生存期较短。我们希望这项研究将有助于通过为每位患者优化治疗来改善未来非小细胞肺癌患者的治疗，这将有助于患者延长生存期。准确确定这些数据有助于为每位患者正确选择最佳治疗方案并优化治疗。
