發(fā)布時(shí)間：2018-07-16 11:51

【摘要】：目的:對(duì)局部晚期老年肺鱗狀細(xì)胞癌患者進(jìn)行回顧性分析,確定影響預(yù)后的因素,預(yù)測(cè)生存期,尋求最佳治療方式。方法:按納入標(biāo)準(zhǔn)搜集2010年1月1日至2015年1月1日就診于山西省腫瘤醫(yī)院的老年肺鱗狀細(xì)胞癌患者162例;對(duì)相關(guān)預(yù)后因素分別進(jìn)行Kaplan-Meier單因素和Cox回歸多因素分析;并對(duì)治療相關(guān)不良反應(yīng)進(jìn)行對(duì)照。結(jié)果:162例患者中位年齡73.6歲,總體中位生存期為19.4月,1年生存率為71.0%,2年生存率為35.9%。Kaplan-Meier單因素分析示:年齡(χ2=7.94,P=0.005)、ECOG評(píng)分(χ2=42.12,P=0.000)、化放療聯(lián)合與否(χ2=14.99,P=0.000)是影響生存的預(yù)后因素。Cox回歸多因素分析示:ECOG評(píng)分(HR=0.299,P=0.000,95%CI為0.193~0.462)、N分期(HR=0.645,P=0.026,95%CI為0.439~0.949)是影響預(yù)后的獨(dú)立因素。治療相關(guān)不良反應(yīng)顯示:化放療聯(lián)合治療組在血液、消化、呼吸系統(tǒng)發(fā)生毒副反應(yīng)的例數(shù)均高于單純放療組,尤其在白細(xì)胞(P=0.000),血小板(P=0.001)、消化道(P=0.000)和急性肺部炎癥(P=0.005)的毒副反應(yīng)經(jīng)χ2檢驗(yàn)具有統(tǒng)計(jì)學(xué)差異(P0.05)。結(jié)論:1.ECOG評(píng)分和N分期是影響未手術(shù)、局部晚期老年肺鱗狀細(xì)胞癌患者生存期的獨(dú)立預(yù)后因素。ECOG評(píng)分越低(0~1分),淋巴結(jié)轉(zhuǎn)移的部位越少(N_(0-1)),生存期越長(zhǎng);反之,生存期越短。2.局部晚期老年肺鱗狀細(xì)胞癌患者行化放療聯(lián)合治療時(shí),更易出現(xiàn)毒副反應(yīng)。
[Abstract]:Objective: to determine the prognostic factors, predict survival and seek the best treatment for the elderly patients with locally advanced lung squamous cell carcinoma (LSCC). Methods: 162 elderly patients with lung squamous cell carcinoma from January 1, 2010 to January 1, 2015 were collected according to the inclusion criteria. Kaplan-Meier univariate analysis and Cox regression multivariate analysis were performed on the prognostic factors. The side effects of treatment were compared. Results the median age of 162 patients was 73.6 years old. The overall median survival time was 19.4 months, the 1-year survival rate was 71.0, and the 2-year survival rate was 35.9.Kaplan-Meier univariate analysis showed that age (蠂 ~ 22n = 7.94) and ECOG score (蠂 ~ 22.12 / P ~ 0.000), chemoradiotherapy and radiotherapy (蠂 ~ 214.99P _ 0.000) were prognostic factors of survival. Cox regression analysis showed that the score of w ECOG (HR0.299P0. 00095CI was 0.1930.462). Stage (HRN 0. 645) (CI = 0. 439 ~ 0. 949) is an independent prognostic factor. Treatment related adverse reactions showed that the number of adverse reactions in blood, digestion and respiratory system in the combined chemotherapy and radiotherapy group was higher than that in the radiotherapy alone group. The side effects of leukocytes (P0. 000), platelets (P0. 001), digestive tract (P0. 000) and acute pulmonary inflammation (P0. 005) were significantly different by 蠂 2 test (P0.05). Conclusion: 1. ECOG score and N stage are the independent prognostic factors of survival period in the elderly patients with locally advanced lung squamous cell carcinoma. The lower the score is (0 ~ 1 score), the less the location of lymph node metastasis is (N0-1), survival time is longer; conversely, the shorter the survival time is. 2. Patients with locally advanced lung squamous cell carcinoma (LSCC) are more likely to develop toxic side effects when combined chemotherapy and radiotherapy.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R734.2

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相關(guān)期刊論文 前1條

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