术前GP新辅助化疗对局部晚期非小细胞肺癌手术患者预后的影响
|
摘要
目的分析术前吉西他滨联合顺铂(GP)新辅助化疗对局部晚期非小细胞肺癌(NSCLC)手术患者预后的影响因素。方法回顾性分析2014年1月—2015年5月收治的121例局部晚期NSCLC患者的临床资料,所有患者均采用手术治疗,其中术前给予GP新辅助化疗患者68例。根据术后是否死亡将患者分存活组40例和死亡组81例,采用非条件单因素和多因素Logistic回归模型分析影响NSCLC手术患者预后死亡的危险因素。结果经单因素分析结果显示,吸烟指数、治疗方式、手术方式和手术并发症是影响NSCLC手术患者预后死亡的相关因素(P<0.05);经非条件多因素Logistic回归模型分析结果显示,吸烟指数>400支/年、直接手术、全肺切除是影响NSCLC手术患者预后死亡的独立危险因素(P<0.05)。结论术前GP新辅助化疗联合手术治疗可以提高局部晚期NSCLC患者的预后生存率,术前未进行GP新辅助化疗是影响患者预后死亡的独立危险因素。
Objective To analyze influencing factors of preoperative neoadjuvant chemotherapy with Gemcitabine and Cisplatin(GP) on prognosis of patients with locally advanced non-small cell lung cancer(NSCLC) undergoing surgery. Methods Clinical data of 121 patients with locally advanced NSCLC admitted during January 2014 and May 2015 was retrospectively analyzed. All patients underwent surgical treatments, which included 68 patients with preoperative GP neoadjuvant chemotherapy. The patients were divided into survival group(n=40) and death group(n=81) according to whether or not having death. Risk factors affecting prognosis and mortality of NSCLC patients were analyzed by unconditional univariate and multivariate logistic regression model. Results Univariate analysis showed that smoking index, therapeutic methods, operative methods and complications were related factors affecting prognosis and mortality of NSCLC patients(P<0.05); unconditional multivariate logistic regression model analysis showed that smoking index more than 400 branches per year, direct operation and total pneumonectomy were independent risk factors affecting prognosis and mortality of NSCLC patients(P<0.05). Conclusion Preoperative GP neoadjuvant chemotherapy combined with surgical treatment may improve prognostic survival rate of patients with locally advanced NSCLC. Preoperative non-GP neoadjuvant chemotherapy is an independent risk factor affecting prognosis and mortality of patients.
Objective To analyze influencing factors of preoperative neoadjuvant chemotherapy with Gemcitabine and Cisplatin(GP) on prognosis of patients with locally advanced non-small cell lung cancer(NSCLC) undergoing surgery. Methods Clinical data of 121 patients with locally advanced NSCLC admitted during January 2014 and May 2015 was retrospectively analyzed. All patients underwent surgical treatments, which included 68 patients with preoperative GP neoadjuvant chemotherapy. The patients were divided into survival group(n=40) and death group(n=81) according to whether or not having death. Risk factors affecting prognosis and mortality of NSCLC patients were analyzed by unconditional univariate and multivariate logistic regression model. Results Univariate analysis showed that smoking index, therapeutic methods, operative methods and complications were related factors affecting prognosis and mortality of NSCLC patients(P<0.05); unconditional multivariate logistic regression model analysis showed that smoking index more than 400 branches per year, direct operation and total pneumonectomy were independent risk factors affecting prognosis and mortality of NSCLC patients(P<0.05). Conclusion Preoperative GP neoadjuvant chemotherapy combined with surgical treatment may improve prognostic survival rate of patients with locally advanced NSCLC. Preoperative non-GP neoadjuvant chemotherapy is an independent risk factor affecting prognosis and mortality of patients.
引文
[1] 邱菊香,严海莹,刘照平,等.冷冻消融对非小细胞肺癌免疫功能的影响[J].解放军医药杂志,2016,28(6S):48-50.
[2] 龚玉芳,刘峰,杨志胤,等.新辅助化疗前后非小细胞肺癌患者血清CA125、CEA及CYFRA21-1的变化及预后分析[J].中国医药导报,2017,14(11):91-94.
[3] 范宜楚,汪笑冬,迟明友,等.术前新辅助化疗对局限期小细胞肺癌预后的影响研究[J].中国全科医学,2016,19(14):1653-1658.
[4] 宋朋,高树庚.ⅠB期NSCLC术后辅助化疗争议及病理预后因素[J].中国肿瘤,2017,26(4):286-290.
[5] Rami-Porta R,Bolejack V,Crowley J,et al.The IASLC lung cancer staging project:proposals for the revisions of the T descriptors in the forthcoming eighth edition of the TNM classification for lung cancer[J].J Thorac Oncol,2015,10(7):990-1003.
[6] Dediu M,Ion O,Ion R,et al.Impact of adjuvant chemotherapy in stage ⅠB non-small-cell lung cancer:an analysis of 112 consecutively treated patients[J].J BUON,2012,17(2):317-322.
[7] 王亚旗,王兴,阎石,等.非小细胞肺癌新辅助治疗联合外科治疗的进展[J].中国肺癌杂志,2017,20(5):352-360.
[8] 张世才,张星星,康维娜,等.康艾辅助序贯放化疗治疗晚期非小细胞肺癌对患者预后(生存率等)及生活质量的影响分析[J].解放军预防医学杂志,2016,34(4):106-107.
[9] 谭庆麟,贾筠,朱介宾.非小细胞肺癌手术联合放化疗的临床研究[J].临床肺科杂志,2016,21(6):1147-1149.
[10] 程远大,张春芳,高阳.miRNA-1靶基因的生物信息学分析[J].医学分子生物学杂志,2016,14(4):193-197,202.
[11] 朱文华,李和根,陈智伟,等.完全性切除术后Ⅲa期非小细胞肺癌患者无病生存期的相关预后因素分析[J].上海中医药大学学报,2017,31(5):22-26.
[12] 宋朋,臧若川,张默言,等.ⅠB期非小细胞肺癌术后预后因素分析[J].中华肿瘤杂志,2017,39(4):393-397.
[13] 袁冬梅,宋勇.非小细胞肺癌治疗新时代:免疫治疗[J].解放军医学杂志,2017,42(6):483-487.
[14] 陶天晓,刘士学,朱健,等.早期非小细胞肺癌患者单操作孔与多操作孔胸腔镜肺叶切除术后生活质量的比较[J].江苏大学学报:医学版,2017,27(5):449-451.
[15] 庞一雄,黄维江,胡磊,等.小细胞肺癌恶性程度与新辅助化疗预后的研究[J].海南医学院学报,2016,22(9):898-901.
[16] 喻小红.综合性中医护理对晚期肺癌患者生活质量的影响[J].保健医学研究与实践,2016,13(5):82-83.
[17] 王梅云,殷星,候永超,等.射频消融术联合同步放化疗并序贯化疗治疗中晚期局部非小细胞肺癌对患者生存质量的影响[J].解放军医药杂志,2016,28(S6):46-48.
[18] 张标,杨军.非小细胞肺癌表皮生长因子受体基因突变236例分析[J].江苏大学学报:医学版,2017,27(2):179-182.
[19] 张尊义,董汉华.Mir-526 b可促进顺铂诱导非小细胞肺癌凋亡[J].医学分子生物学杂志,2016,14(4):208-211.
[20] 骆雯,张匠.三维适形放疗对非小细胞肺癌患者肺功能的影响[J].保健医学研究与实践,2014,11(6):37-39.
[2] 龚玉芳,刘峰,杨志胤,等.新辅助化疗前后非小细胞肺癌患者血清CA125、CEA及CYFRA21-1的变化及预后分析[J].中国医药导报,2017,14(11):91-94.
[3] 范宜楚,汪笑冬,迟明友,等.术前新辅助化疗对局限期小细胞肺癌预后的影响研究[J].中国全科医学,2016,19(14):1653-1658.
[4] 宋朋,高树庚.ⅠB期NSCLC术后辅助化疗争议及病理预后因素[J].中国肿瘤,2017,26(4):286-290.
[5] Rami-Porta R,Bolejack V,Crowley J,et al.The IASLC lung cancer staging project:proposals for the revisions of the T descriptors in the forthcoming eighth edition of the TNM classification for lung cancer[J].J Thorac Oncol,2015,10(7):990-1003.
[6] Dediu M,Ion O,Ion R,et al.Impact of adjuvant chemotherapy in stage ⅠB non-small-cell lung cancer:an analysis of 112 consecutively treated patients[J].J BUON,2012,17(2):317-322.
[7] 王亚旗,王兴,阎石,等.非小细胞肺癌新辅助治疗联合外科治疗的进展[J].中国肺癌杂志,2017,20(5):352-360.
[8] 张世才,张星星,康维娜,等.康艾辅助序贯放化疗治疗晚期非小细胞肺癌对患者预后(生存率等)及生活质量的影响分析[J].解放军预防医学杂志,2016,34(4):106-107.
[9] 谭庆麟,贾筠,朱介宾.非小细胞肺癌手术联合放化疗的临床研究[J].临床肺科杂志,2016,21(6):1147-1149.
[10] 程远大,张春芳,高阳.miRNA-1靶基因的生物信息学分析[J].医学分子生物学杂志,2016,14(4):193-197,202.
[11] 朱文华,李和根,陈智伟,等.完全性切除术后Ⅲa期非小细胞肺癌患者无病生存期的相关预后因素分析[J].上海中医药大学学报,2017,31(5):22-26.
[12] 宋朋,臧若川,张默言,等.ⅠB期非小细胞肺癌术后预后因素分析[J].中华肿瘤杂志,2017,39(4):393-397.
[13] 袁冬梅,宋勇.非小细胞肺癌治疗新时代:免疫治疗[J].解放军医学杂志,2017,42(6):483-487.
[14] 陶天晓,刘士学,朱健,等.早期非小细胞肺癌患者单操作孔与多操作孔胸腔镜肺叶切除术后生活质量的比较[J].江苏大学学报:医学版,2017,27(5):449-451.
[15] 庞一雄,黄维江,胡磊,等.小细胞肺癌恶性程度与新辅助化疗预后的研究[J].海南医学院学报,2016,22(9):898-901.
[16] 喻小红.综合性中医护理对晚期肺癌患者生活质量的影响[J].保健医学研究与实践,2016,13(5):82-83.
[17] 王梅云,殷星,候永超,等.射频消融术联合同步放化疗并序贯化疗治疗中晚期局部非小细胞肺癌对患者生存质量的影响[J].解放军医药杂志,2016,28(S6):46-48.
[18] 张标,杨军.非小细胞肺癌表皮生长因子受体基因突变236例分析[J].江苏大学学报:医学版,2017,27(2):179-182.
[19] 张尊义,董汉华.Mir-526 b可促进顺铂诱导非小细胞肺癌凋亡[J].医学分子生物学杂志,2016,14(4):208-211.
[20] 骆雯,张匠.三维适形放疗对非小细胞肺癌患者肺功能的影响[J].保健医学研究与实践,2014,11(6):37-39.