摘要
目的:分析老年非小细胞肺癌患者的临床特点和预后因素。方法:回顾性分析150例老年(年龄≥70岁)非小细胞肺癌患者临床资料。采用单、多因素分析评估患者临床病理特征和预后因素。结果:150名患者中,临床分期为Ⅲ-Ⅳ的晚期肺癌的患者例数为135例。约4/5患者是男性并且超过70%男性患者有吸烟史。首发症状主要表现为咳嗽、咳痰,其中20%患者伴发慢性肺部疾病。单因素分析,经过综合治疗或者单纯手术治疗患者中位生存时间(22月,29月)均高于仅接受最佳支持治疗的患者(10月,P<0.05)。女性患者(n=32)中位生存时间高于男性(n=118),分别为22月,14月(P<0.05)。80岁以上组患者中位生存时间(4月)明显下降,与70-75岁(16月),76-80岁组(13月)之间具有显著性差异(P<0.01)。6月内体重减轻(>5%)2年生存率明显低于于体重未减轻者,分别为12.07%,48.91%(P<0.01)。ECOG评分≤2分2年生存率明显优于ECOG评分>2分,分别为41.18%,20.83%(P<0.05)。多因素分析显示,体重减轻超过5%(HR=34.907,P<0.01)、年龄大于80岁(HR=10.91,P<0.01)和仅接受最佳支持治疗(HR=6.074,P<0.05)都是影响预后的独立因素。结论:老年非小细胞肺癌接受治疗可获益,女性,年龄相对较小,ECOG评分≤2分,接受手术治疗以及综合治疗者生存期较长,预后较好,体重减轻和仅接受最佳支持治疗患者预后差。
Objective： To analyze prognostic factors and clinic pathological features of elderly patients with nonsmall cell lung cancer（NSCLC）.Methods： A total of 150 elderly NSCLC patients（age ≥70 years） were retrospectively reviewed.The clinic pathological features and prognostic factors were evaluated by univariate and multivariate analysis.Results： Among the 150 cases with median age of 73 years,advanced lung cancer（clinical stage of Ⅲa-Ⅳ） accounted for 90% of the cases.118 patients were males and 70% of all were smokers.The onset symptoms were cough,sputum,etc.20% patients had chronic lung disease.Of the 150 patients,133 received chemotherapy,radiotherapy or surgery,the rest 17 received best supportive care（BSC） therapy.The median survival time of multimodality therapy group（22 months） and single surgical group（29 months） were significantly higher than in BSC group（10 months, P 0.05）.The median survival time of female patients was 22 months,higher than that of males’patients（14 months,P 0.05）.The older patients had the lower survival rate,especially for who’re older than 80.The 2-years survival rate were 12.07% and 48.91%（P 0.01） respectively in group that lose weight more than 5% in 6 months and group that lose weight less than 5%.The 2-years survival rate in ECOG≤2 group was 41.18% versus 20.83% in ECOG 2 group（P 0.05）.Multivariate analysis of prognostic factors using COX’s proportional hazard model showed that weight loss more than 5%,older than 80 years,BSC-treatment-only were the independent prognostic factors.Conclusion： Female, relatively young patients,ECOG≤2 and multimodality treatment were beneficial prognostic factors in elderly NSCLC patients.The elderly patients tend to have longer life expectance when diagnosed in early stage and with good performance status,whereas resection and multidisciplinary treatments may prolong the survival time.
出处
《武汉大学学报（医学版）》
CAS
北大核心
2013年第3期372-376,共5页
Medical Journal of Wuhan University
基金
湖北省自然科学基金杰出青年基金资助项目(编号:2008CDB126)
关键词
肺肿瘤
老年医学
生存
预后
Lung Neoplasm
Gerriatrics
Survival
Prognosis
