Sakurai M, Shinkai T, Eguchi K, Sasaki Y, Tamura T, Miura K, Fujiwara Y, Otsu A, Horiuchi N, Nakano H
Department of Internal Medicine, National Cancer Center Hospital, Tokyo, Japan.
J Cancer Res Clin Oncol. 1987;113(6):563-6. doi: 10.1007/BF00390866.
A total of 190 patients with unresectable non-small cell lung cancer (NSCLC) were analyzed retrospectively using eight pretreatment and three treatment-related prognostic factors in terms of influence on survival. All the patients received chemotherapy with or without chest irradiation, according to the protocol of phase II or phase III trials of the National Cancer Center Hospital Tokyo between April 1980 and December 1985. The eight pretreatment factors selected were performance status, sex, stage, age, histology, and metastasis to brain, bone or, liver. Three treatment-related factors were radiation therapy to the primary site, response to chemotherapy, and treatment period, before or after clinical administration of cis-diamminedichloroplatinum (II) (CDDP). Of the 190 patients, 71 (37.4%) were alive for more than 1 year, but only 17 patients (8.9%) survived 2 years after the initiation of chemotherapy. By univariate analysis, performance status 0-1, female, no metastasis to bone or liver, response to chemotherapy, and treatment period after CDDP were considered to be favorable prognostic factors. By multiregression analysis, performance status, sex, and treatment period after CDDP proved to be important factors for long-term survival. Consideration of these prognostic factors could enable the results of chemotherapy to be more accurately evaluated, and stratification of patients with advanced NSCLC based on performance status and sex before entry into a randomized controlled trial is recommended.
回顾性分析了190例无法切除的非小细胞肺癌(NSCLC)患者,研究8个治疗前因素和3个与治疗相关的预后因素对生存的影响。根据东京国立癌症中心医院1980年4月至1985年12月进行的II期或III期试验方案,所有患者均接受了化疗,部分患者还接受了胸部放疗。所选的8个治疗前因素为体能状态、性别、分期、年龄、组织学类型以及脑、骨或肝转移情况。3个与治疗相关的因素为原发部位的放射治疗、对化疗的反应以及顺二氯二氨铂(II)(CDDP)临床应用前后的治疗周期。190例患者中,71例(37.4%)存活超过1年,但化疗开始后仅17例(8.9%)存活2年。单因素分析显示,体能状态0 - 1级、女性、无骨或肝转移、对化疗有反应以及CDDP应用后的治疗周期被认为是有利的预后因素。多因素回归分析表明,体能状态、性别以及CDDP应用后的治疗周期是长期生存的重要因素。考虑这些预后因素能够更准确地评估化疗效果,建议在晚期NSCLC患者进入随机对照试验前,根据体能状态和性别进行分层。