Prognostic factor analysis of elderly patients with small-cell lung cancer

Yi-xia Yin, Zhangzhou Huang, Yunjian Huang, Biao Wu
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Abstract

Objective To retrospectively analyze clinical data of elderly patients with small-cell lung cancer(SCLC)in order to investigate their prognostic factors. Methods Clinical data of SCLC patients aged 65 years and over in our hospital from January 2006 to February 2017 were analyzed.Survival data were analyzed by Kaplan-Meier method.Univariate analysis of prognosis was conducted by Log rank test.Multivariate analysis was performed by Cox regression. Results A total of 143 patients were enrolled, the median overall survival(OS)was 17.9 months, with 21.3 months for limit stage(LD)and 9.6 months for extensive stage(ED). For LD patients, age(HR=18.688, 95%CI: 3.237-107.889), smoking index(HR=2.783, 95%CI: 1.196-6.475), thoracic irradiation(HR=0.305, 95%CI: 0.120-0.779), chemotherapy efficacy(HR=0.210, 95%CI: 0.065-0.685)were the independent risk factors for the prognosis.For ED patients, chemotherapy cycles(HR=0.461, 95%CI: 0.229-0.927)and performance status(HR=0.422, 95%CI: 0.218-0.818)were the independent risk factors for prognosis. Conclusions Smoking index, tumor stage and treatment mode can influence the survival of SCLC patients.The LD patients, who were aged less than 75 years, with smoking index less than 1000, receiving thoracic irradiation and achieving remission with chemotherapy, show a longer OS.For ED patients, a good performance status and sufficient chemotherapy can predict an improved OS. Key words: Smallcell lung carcinoma; Prognosis
老年小细胞肺癌患者预后因素分析
目的回顾性分析老年癌症(SCLC)患者的临床资料,探讨其预后因素。方法分析2006年1月至2017年2月我院65岁及以上SCLC患者的临床资料。生存数据采用Kaplan-Meier方法进行分析。预后的单因素分析采用对数秩检验。采用Cox回归进行多变量分析。结果共有143例患者入选,中位总生存期(OS)为17.9个月,其中局限期(LD)为21.3个月、广泛期(ED)为9.6个月。对于LD患者,年龄(HR=18.688,95%CI:3.237-107.889)、吸烟指数(HR=2.783,95%CI:1.196-6.475)、胸部照射(HR=0.305,95%CI:0.10-20-779)、化疗疗效(HR=0.210,95%CI:0.065-0.685)是影响预后的独立危险因素。ED患者的化疗周期(HR=0.461,95%CI:0.29-0.927)和表现状态(HR=0.422,95%CI:0.218-0.818)是影响预后的独立危险因素。结论吸烟指数、肿瘤分期及治疗方式对SCLC患者的生存有影响。年龄小于75岁、吸烟指数小于1000、接受胸部放疗并通过化疗获得缓解的LD患者表现出较长的OS。对于ED患者,良好的表现状态和充足的化疗可以预测OS的改善。关键词:小细胞肺癌;预后
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