不可手术局部晚期非小细胞肺癌放化疗安全性及疗效分析

发布时间：2018-11-14 07:27

【摘要】：目的回顾性分析不可手术局部晚期非小细胞肺癌(LA-NSCLC)的放化疗疗效和安全性及影响其预后的因素。方法收集2010年1月至2015年12月于我科治疗的不可手术LA-NSCLC患者98例。其中单纯放疗组26例、同步放化疗组37例、序贯放化疗组35例,统计其无进展生存期(PFS)及总生存时间(OS)。采用Kaplan-Meier绘制生存曲线,并用log-rank/Breslow检验进行组间比较;单因素和COX多因素回归分析PFS和OS的独立预后因素。结果序贯放化疗组的中位PFS优于单纯放疗组,同步及序贯放化疗的中位OS均优于单纯放疗组(P0.05)。较早的淋巴结分期、双药联合化疗及联合应用放化疗是PFS获益的独立影响因素;较早的淋巴结分期是OS获益的独立影响因素;总体治疗安全性良好,血液学毒性与化疗方案及患者的KPS评分相关(P0.05)。结论对于LA-NSCLC,较早的淋巴结分期、双药联合化疗及联合应用放化疗治疗是PFS获益的独立影响因素;较早的淋巴结分期是OS获益的独立影响因素。总体治疗安全性良好,但联合化疗和较低的KPS评分会增加血液学毒性。
[Abstract]:Objective to retrospectively analyze the efficacy and safety of radiotherapy and chemotherapy in non-operative advanced non-small cell lung cancer (LA-NSCLC) and its prognostic factors. Methods from January 2010 to December 2015, 98 patients with non-operative LA-NSCLC were collected. There were 26 cases in radiotherapy alone group, 37 cases in concurrent radiotherapy and chemotherapy group and 35 cases in sequential chemotherapy group. The progressive survival time (PFS) and total survival time (OS).) were calculated. Kaplan-Meier was used to draw survival curve, and log-rank/Breslow test was used to compare the survival curve. Univariate and COX multivariate regression analysis was used to analyze the independent prognostic factors of PFS and OS. Results the median PFS of sequential radiotherapy and chemotherapy group was better than that of radiotherapy alone group, and the median OS of simultaneous and sequential radiotherapy group was better than that of radiotherapy alone group (P0.05). Early lymph node staging, combined chemotherapy with two drugs and combined radiotherapy and chemotherapy were independent influencing factors for the benefit of PFS, and earlier lymph node staging was the independent influencing factor for the benefit of OS. The overall safety of the treatment was good. Hematological toxicity was correlated with chemotherapy regimen and KPS score of patients (P0.05). Conclusion for the earlier lymph node staging of LA-NSCLC, double drug combined chemotherapy and combined radiotherapy and chemotherapy are independent influencing factors for the benefit of PFS, and earlier lymph node staging is the independent influencing factor for the benefit of OS. The overall safety of the treatment was good, but combination chemotherapy and lower KPS scores increased hematological toxicity.
【作者单位】：中国医科大学附属盛京医院肿瘤科;
【分类号】：R734.2

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