不同治疗方案对70岁以上晚期肺腺癌患者生存期的影响

摘要

Objective To explore the efficacy of different therapies for advanced elderly lung adenocarcino -ma patients.Methods 67 elderly lung adenocarcinoma patients (≥70years) from 2009 to 2014 were divided into 3 groups according to different therapy .The group A was given EGFR-TKI, the group B was given chemotherapy , and the group C was given the best support care (BSC).Further, the group B was divided into 3 subgroups, included chemotherapy only as the group B 1, EGFR-TKI during chemotherapy period as the group B 2, and patients failed in chemotherapy of the 4-6 cycles as the group B3.One and two-year survival rate, progression free survival (PFS) and median survival time (MST) were compared.Results One-year survival rate in the group A (35.3%) and the group B (40.0%) were both higher than that in the group C (6.6%) (P<0.05), with no significant difference be-tween the group A and B .Two-year survival rate was 17.6%, 25.7% and 0.0% respectively in the group A , B, and C.The PFS of the group A was 2.2 months longer than that of the group B .There was no significant difference in MST between the group A (8.2 months) and the group B (9.1 months), but both of them were longer than that in the group C (3.4 months) (P<0.05).In the subgroup analysis, both the one-year survival rate of the group B1 (46.7%) and the group B2(58.3%) were significantly higher than that of the group B 3 (0.0%) (P<0.05).PFS was 5.1 months, 4.5 months and 2.4 months.The MST of the group B1 (11.7 months) and the group B2 (15.1 months) were both significantly longer than that of the group C (3.2 months) (P<0.01).The MST of the group B1 was prolonged by 3.7 months compared with the group A (P<0.05).Conclusion As to the elderly lung adenocar-cinoma patients , both EGFR-TKI therapy and chemotherapy are more effective than BSP .There might be benefit for these patients by combining with EGFR-TKI during chemotherapy .%目的：探讨不同治疗方案对70岁以上晚期肺腺癌患者预后的影响。方法回顾分析67例70岁以上晚期肺腺癌患者的治疗经过，根据所接受的治疗分为3组：靶向治疗组（A组）、化疗组（B组）和最佳支持治疗组（C组）。进一步将B组分为3个亚组：单纯化疗并完成首次4～6个治疗周期（B1组），在治疗中使用过靶向药物（ B两组）和未完成4－6个化疗周期的患者（ B3组），比较各组患者1年生存率，2年生存率，无进展生存期及生存期的差异。结果 A、B两组的1年生存率（35.3％，40.0％）均高于C组（6.6％）（ P＜0.01），三组患者的2年生存率无显著差异。 A、B两组的无进展生存期（6.9月，4.7月）均高于C组（2.2月）（P＜0.05）。 A、B两组的中位生存期无显著差异（8.2月，9.1月），均高于C组（3.4月）（P＜0.01）。在亚组分析中，B1组和B两组的1年生存率高于B3组（分别为46.7％、58.3％及0.0％）（ P＜0.05 ），3组患者的2年生存率分别为26.7％，41.7％和0.0％。 B1组（5.1月）与B两组（4.5月）的无进展生存期均高于B3组（2.4月）（P＜0.01）。3组患者的中位生存期分别为11.7月，15.1月和3.2月，B1、B两组高于B3组（P＜0.01）。 B1组的中位生存期比A组增加了3.7月（P＜0.05）。结论对于老年晚期肺癌患者，化疗或靶向治疗疗效均优于最佳支持组。化疗联合或交替使用靶向药物可能使该患者群体受益。