Medical University Innsbruck, Department of Internal Medicine V (Haematology and Oncology), Innsbruck, Austria; Tyrolean Cancer Research Institute, Innsbruck, Austria.
Medical University Innsbruck, Department of Internal Medicine V (Haematology and Oncology), Innsbruck, Austria; Wilhelminenspital Wien, Department of Internal Medicine I (Haematology and Oncology), Vienna, Austria.
Lung Cancer. 2015 Feb;87(2):193-200. doi: 10.1016/j.lungcan.2014.12.006. Epub 2014 Dec 18.
The aim of this study was to describe a large consecutive cohort of non-small cell lung cancer (NSCLC) patients treated in daily routine within the last 25 years. An extensive list of general baseline characteristics (comorbidities, laboratory values, symptoms, performance state), NSCLC related factors (stage, histology), treatment related parameters (approach, applied therapies) and outcome (PFS, RFS, OS, perspective of decades) were analyzed in detail.
Medical files of 2293 consecutive NSCLC patients diagnosed between 1989 and 2009 at the Medical University of Innsbruck and affiliated hospitals were retrospectively analyzed. Patients were documented within our institution's comprehensive lung cancer project "Twenty-Year Retrospective of Lung Cancer (TYROL study)".
Mean age at diagnosis was 64.1 years and 1611 patients (70.3%) were male. Most patients were diagnosed in stage IV (37.9%). The most frequent comorbidities present at diagnosis were cardiovascular disease (62.1%) and COPD (62.0%). The most common symptoms at diagnosis were coughing (54.7%) and dyspnea (45.3%). Of all 2293 patients 1981 (86.4%) received adequate antineoplastic treatment. In total 874 patients were radically operated, 119 received radiotherapy/radio-chemotherapy and the majority of patients (n=1278) were treated in palliative intent. A 2nd, 3rd, 4th and 5th-line palliative therapy was administered to 612, 278, 102, and 36 patients. Median OS, RFS and PFS were 16.4 months, 86.4 months and 5.1 months, respectively. A multitude of factors was associated with all three outcome variables. Of note, outcome has improved stepwise in the recent decade based on increased response rates leading to prolonged OS.
This work incorporates most clinical aspects relevant in the treatment of NSCLC and beyond. Therefore, this comprehensive analysis provides a definite benchmark for prognostication and epidemiology of NSCLC in a Western European society.
本研究旨在描述过去 25 年中在日常实践中接受治疗的大量非小细胞肺癌（NSCLC）患者。详细分析了广泛的一般基线特征（合并症、实验室值、症状、表现状态）、NSCLC 相关因素（分期、组织学）、治疗相关参数（方法、应用的疗法）和结局（PFS、RFS、OS、几十年的展望）。
回顾性分析了 1989 年至 2009 年在因斯布鲁克医科大学及其附属医院诊断的 2293 例连续 NSCLC 患者的医疗档案。患者在我们机构的综合肺癌项目“肺癌二十年回顾（TYROL 研究）”中进行了记录。
诊断时的平均年龄为 64.1 岁，1611 例（70.3%）为男性。大多数患者被诊断为 IV 期（37.9%）。诊断时最常见的合并症是心血管疾病（62.1%）和 COPD（62.0%）。最常见的诊断症状是咳嗽（54.7%）和呼吸困难（45.3%）。在所有 2293 例患者中，1981 例（86.4%）接受了适当的抗肿瘤治疗。总共 874 例患者接受根治性手术，119 例接受放疗/放化疗，大多数患者（n=1278）接受姑息治疗。612 例、278 例、102 例和 36 例患者接受了二线、三线、四线和五线姑息治疗。中位 OS、RFS 和 PFS 分别为 16.4 个月、86.4 个月和 5.1 个月。多种因素与所有三个结局变量相关。值得注意的是，基于反应率的提高导致 OS 延长，最近十年的治疗效果逐步提高。
这项工作纳入了 NSCLC 治疗及其他方面的大多数临床相关因素。因此，这种全面分析为西欧社会 NSCLC 的预后和流行病学提供了明确的基准。
