154例小细胞肺癌预后因素分析
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摘要
目的分析小细胞肺癌(Small Cell Lung Cancer,SCLC)的生存状况及预后的相关因素。方法收集154例经病理或细胞学确诊的SCLC患者的临床资料,分析影响预后的因素。结果 (1)1年生存率局限期84.0%,广泛期54.9%,全组65.6%,中位生存期(Median Survival Time,MST)局限期24个月,广泛期13个月,全组15个月。(2)单因素分析局限期男性、胸部放疗者MST明显延长,广泛期性别、肝转移、化疗周期、胸部放疗影响患者预后。(3)多因素分析肝转移、化疗周期为独立预后因素。(4)全组分析性别、分期可能是预后影响因素,肝转移、化疗周期、胸部放疗是独立影响因素。结论性别、分期可能与SCLC生存相关,肝转移、化疗周期、胸部放疗是影响SCLC预后的独立因素。
Objective To evaluate the survival state and prognostic factors of patients with small cell lung cancer. Methods The clinical data were collected from 154 patients with small cell lung cancer who were diagnosed by histopathology or cytology. The prognostic factors were analyzed. Results(1) The 1-year survival rate was 84.0% in limited disease( LD) patients,and 54. 9% in extensive disease( ED) patients,and 65. 6% in all patients.The median survival time( MST) of LD-SCLC was 24 months and 13 months in ED-SCLC,and 15 months in all the patients respectively.(2) Univariate analysis indicated that male and thoracic radiotherapy benefited the survival state in LD-SCLC,and sex,liver metastases,the cycle number of chemotherapy and thoracic radiotherapy significantly influenced survival state in ED-SCLC.(3) Multivariate analysis suggested that liver metastases and the cycle number of chemotherapy were independent prognostic factors.(4) Sex and staging influenced survival state. Liver metastases,the cycle number of chemotherapy and thoracic radiotherapy were the independent prognostic factors. Conclusion The survival time is related to sex and stage,liver metastases,the cycle number of chemotherapy and thoracic radiotherapy were the independent prognostic factors.
Objective To evaluate the survival state and prognostic factors of patients with small cell lung cancer. Methods The clinical data were collected from 154 patients with small cell lung cancer who were diagnosed by histopathology or cytology. The prognostic factors were analyzed. Results(1) The 1-year survival rate was 84.0% in limited disease( LD) patients,and 54. 9% in extensive disease( ED) patients,and 65. 6% in all patients.The median survival time( MST) of LD-SCLC was 24 months and 13 months in ED-SCLC,and 15 months in all the patients respectively.(2) Univariate analysis indicated that male and thoracic radiotherapy benefited the survival state in LD-SCLC,and sex,liver metastases,the cycle number of chemotherapy and thoracic radiotherapy significantly influenced survival state in ED-SCLC.(3) Multivariate analysis suggested that liver metastases and the cycle number of chemotherapy were independent prognostic factors.(4) Sex and staging influenced survival state. Liver metastases,the cycle number of chemotherapy and thoracic radiotherapy were the independent prognostic factors. Conclusion The survival time is related to sex and stage,liver metastases,the cycle number of chemotherapy and thoracic radiotherapy were the independent prognostic factors.
引文
[1]PIETANZA M C,BYERS L A,MINNA J D,et al.Small Cell Lung Cancer:Will Recent Progress Lead to Improved Outcomes[J].Clin Cancer Res,2015,21(10):2244-2255.
[2]陈筱玲,方健,聂鋆,等.160例老年小细胞肺癌预后多因素分析[J].中国肺癌杂志,2014,17(1):15-23.
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[5]马满姣,王孟昭,徐燕,等.单中心394例广泛期小细胞肺癌的一线化疗及生存分析[J].中国肺癌杂志,2014,17(1):8-14.
[6]丁妍,岳萌,张玲玲,等.小细胞肺癌的免疫表型特征及其预后分析[J].中国全科医学,2015,18(18):2131-2135.
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[9]赵惠,姚天春,段建春.321例小细胞肺癌一线治疗疗效及预后因素分析[J].临床肺科杂志,2017,22(11):2059-2064.
[10]柳影,朱晶,刘显红,等.91例小细胞肺癌预后的回顾性多因素分析[J].中国肺癌杂志,2014,17(8):588-595.
[11]赵传多,杨龙海,高树庚,等.Ⅱ-ⅢA期小细胞肺癌外科治疗临床研究[J].中国医刊,2015,50(5):46-49.
[12]WONG A T,RINEER J,SCHWARTZ D,et al.Assessing the impact of postoperative radiation therapy for completely resected limite D-stage small cell lung cancer using the national cancer database[J].J Thorac Oncol,2016,11(2):242-248.
[13]赵辉,谷俊东,滑峰,等.放疗时间选择对局限期小细胞肺癌预后影响的meta分析[J].中国肺癌杂志,2010,13(9):892-897.
[14]SLOTMAN B J,VAN TINTEREN H,PRAAG J O,et al.Use of thoracic radiotherapy for extensive stage small-cell lung cancer:a phase 3 randomised controlled tria[J]Lancet,2015,385(9962):36-42.
[15]王永志.预防性全脑照射对小细胞肺癌患者的临床效果观察[J].吉林医学,2015,36(14):3066.
[16]WEAVER H,COONAR A S.Lung cancer:diagnosis,staging and treatment[J].Surgery(Oxford),2017,35(5):247-254.
[17]TAKAHASHI T,YAMANAKA T,SETO T,et al.Prophylactic cranial irradiation versus observation in patients with extensive-disease small-cell lung cancer:a multicentre,randomised,open-label,phase 3 trial[J].Lancet Oncol,2017,18(5):663-671.
[18]邵蔚,马俊勋,陶海涛,等.预防性脑照射与替莫唑胺单药预防小细胞肺癌脑转移的比较[J].解放军医学院学报,2017,38(6):493-496.
[2]陈筱玲,方健,聂鋆,等.160例老年小细胞肺癌预后多因素分析[J].中国肺癌杂志,2014,17(1):15-23.
[3]CAI Q,LUO H L,GAO X C,et al.Clinical Features and Prognostic Factors of Small Cell Lung Cancer:A Retrospective Study in 148Patients[J].J Huazhong Univ Sci Technolog Med Sci,2016,36(6):916-922.
[4]WANG X,ZHANG Y,HU M,et al.Prognostic and Predictive Value of Thyroid Transcription Factor-1,CD56,P40 and Other Clinical Characteristics in Small Cell Lung Cancer Patients[J].Zhongguo Fei Ai Za Zhi,2017,20(8):522-527.
[5]马满姣,王孟昭,徐燕,等.单中心394例广泛期小细胞肺癌的一线化疗及生存分析[J].中国肺癌杂志,2014,17(1):8-14.
[6]丁妍,岳萌,张玲玲,等.小细胞肺癌的免疫表型特征及其预后分析[J].中国全科医学,2015,18(18):2131-2135.
[7]ZHANG C,SCHMIDT L A,HATANAKA K,et al.Evaluation of napsin A,TTF-1,p63,p40,and CK5/6 immunohistochemical stains in pulmonary neuroendocrine tumors[J].Am J Clin Pathol,2014,142(3):320-324.
[8]National Comprehensive Cancer Network(NCCN).NCCN Clinical Practice Guidelines in Oncology.Small Cell Lung Cancer,Version2.2017[S/OL].https://www.nccn.org/professionals/physician gls/f guidelines.asp.
[9]赵惠,姚天春,段建春.321例小细胞肺癌一线治疗疗效及预后因素分析[J].临床肺科杂志,2017,22(11):2059-2064.
[10]柳影,朱晶,刘显红,等.91例小细胞肺癌预后的回顾性多因素分析[J].中国肺癌杂志,2014,17(8):588-595.
[11]赵传多,杨龙海,高树庚,等.Ⅱ-ⅢA期小细胞肺癌外科治疗临床研究[J].中国医刊,2015,50(5):46-49.
[12]WONG A T,RINEER J,SCHWARTZ D,et al.Assessing the impact of postoperative radiation therapy for completely resected limite D-stage small cell lung cancer using the national cancer database[J].J Thorac Oncol,2016,11(2):242-248.
[13]赵辉,谷俊东,滑峰,等.放疗时间选择对局限期小细胞肺癌预后影响的meta分析[J].中国肺癌杂志,2010,13(9):892-897.
[14]SLOTMAN B J,VAN TINTEREN H,PRAAG J O,et al.Use of thoracic radiotherapy for extensive stage small-cell lung cancer:a phase 3 randomised controlled tria[J]Lancet,2015,385(9962):36-42.
[15]王永志.预防性全脑照射对小细胞肺癌患者的临床效果观察[J].吉林医学,2015,36(14):3066.
[16]WEAVER H,COONAR A S.Lung cancer:diagnosis,staging and treatment[J].Surgery(Oxford),2017,35(5):247-254.
[17]TAKAHASHI T,YAMANAKA T,SETO T,et al.Prophylactic cranial irradiation versus observation in patients with extensive-disease small-cell lung cancer:a multicentre,randomised,open-label,phase 3 trial[J].Lancet Oncol,2017,18(5):663-671.
[18]邵蔚,马俊勋,陶海涛,等.预防性脑照射与替莫唑胺单药预防小细胞肺癌脑转移的比较[J].解放军医学院学报,2017,38(6):493-496.