70岁以上老年人非小细胞肺癌的生存研究

背景与目的随着全球的老龄化,老年人疾病受到越来越广泛的关注。肺癌是典型的老年人疾病,大约三分之一的非小细胞肺癌患者年龄超过70岁。国际上文献大多数也以70岁作为老年人肺癌的划分界限。本文的目的是研究70岁以上老年人非小细胞肺癌的生存状况,分析影响其预后的因素。方法回顾性研究148例70岁以上老年人非小细胞肺癌患者的临床资料,利用SPSS13.0统计软件COX回归模型分析性别、年龄、吸烟、症状、病理类型、分期、ECOG状态评分、合并症、手术、放疗、化疗等11个预后因素对生存期的影响。结果随访5-168个月,死亡119例,存活率19.6%。1、2、3、5年生存率分别为43.2%、19.0%、9.5%、5.4%,中位生存期9.29个月。COX回归多因素分析显示,影响预后的独立因素是:临床分期(P=0.002)、ECOG评分(P=0.000)、病灶手术切除(P=0.012)和原发灶放疗(P=0.012)。结论临床分期早及身体状态好的老年非小细胞肺癌患者生存时间长,病灶切除手术及原发灶放疗可以延长其生存期。

Survival Analysis of Non-Small Cell Lung Cancer in Patients aged 70 and over

Background and Objective With a trend of worldwide increasing incidence of elderly population,more and more people pay close attention to diseases in the elderly.Lung cancer is a typical disease of the elderly patients.Around one-third of all patients with non-small cell lung cancer(NSCLC) are over the age of 70.Many authors use the age 70 to define the elderly patients in lung cancer.The objective of this study is to evaluate the survival of patients older than 70 with NSCLC and explore the independent prognostic factors in this group of patients.Methods 148 elderly patients with NSCLC were reviewed.All the potential prognostic factors,including sex,age,smoke,symptoms,pathological types,clinical stage,ECOG performance status,complication,focus resection,radiotherapy and chemotherapy were analyzed by COX regression in SPSS 13.0 software.Results After 5-168 months follow-up,119 patients died,the overall survival rate was 19.6%.1,2,3,5-year survival rates were 43.2%,19.0%,9.0% and 5.4% respectively.Median survival time(MST) was 9.29 moths.COX regression showed clinical stage(P=0.002),ECOG performance status(P=0.000),focus resection(P=0.012) and radiotherapy of primary site(P=0.012)were the independent prognostic factors.Conclusion The elderly patients with NSCLC in early stage and good performance status tend to have longer life expectance,whereas resection and radiotherapy of primary site can prolong the survival time(P<0.05).