【摘要】 目的探讨未手术的老年局部晚期肺鳞状细胞癌病人病情进展的相关因素,实现对病情的预测。方法回顾性分析139例未手术的老年局部晚期肺鳞状细胞癌病人,对影响病情进展的危险因素分别进行单因素和多因素分析。结果入选的139例病人第1、2年的生存率分别为57. 2%、17. 8%,无局部复发率分别为31. 6%、2. 6%,无远处转移率分别为29. 9%、7. 2%。Kaplan-meier单因素分析显示,初期体质量减轻、T分期、N分期及治疗方式是影响局部复发的相关因素;美国东部肿瘤协作组(ECOG)评分、初期体质量减轻、治疗方式是影响远处转移的相关因素。COX回归多因素分析显示,单纯化疗是影响局部复发的独立因素(HR=6. 466,P=0. 000);单纯化疗(HR=1. 708,P<0. 05)、ECOG评分(HR=0. 525,P<0. 01)和初期体质量减轻(HR=0. 364,P<0. 01)是影响远处转移的独立因素。结论未手术的老年局部晚期肺鳞状细胞癌病人行单纯化疗更易局部复发及远处转移。ECOG评分、初期体质量减轻与发生远处转移有关。更多还原

【Abstract】 Objective To analysis of affecting factors of disease progression in elderly patients with locally advanced squamous cell lung cancer( LA-SCLC). Methods A total of 139 elderly patients with LA-SCLC who didn’t receive operation were selected and the clinical data were analyzed retrospectively. Risk factors of disease progression were analyzed by univariate and multivariate analysis respectively. Results Among the 139 patients,the 1-,2-year survival rates were 57. 2%,17. 8%; the1-,2-year local recurrence-free rates were 31. 6%,2. 6%; the 1-,2-year distant metastasis-free rates were 29. 9%,7. 2%. Univariate analysis with Kaplan-meier showed that initial body weight loss,T stage,N stage and therapeutic methods were related factors affecting local recurrence; ECOG score,initial body weight loss,therapeutic methods were factors associated with distant metastasis. Multivariate analysis with COX regression showed that chemotherapy alone was the independent factor affecting local recurrence( HR = 6. 466,P = 0. 000); Chemotherapy alone( HR = 1. 708,P<0. 05),ECOG score( HR = 0. 525,P<0. 01),initial body weight loss( HR = 0. 364,P<0. 01) were the independent factors associated with distant metastasis. Conclusions Chemotherapy alone is more likely to cause local recurrence and distant metastasis in the elderly patient with LA-SCLC. ECOG score, initial body weight loss are associated with distant metastasis.更多还原