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肺癌恶性胸腔积液老年患者预后的相关影响因素分析 被引量:5

Influencing factors for prognosis of elderly patients with malignant pleural effusion of lung cancer
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摘要 目的:分析肺癌恶性胸腔积液老年患者预后的相关影响因素。方法:收集2017年7月至2019年1月本院收治的肺癌恶性胸腔积液患者80例,患者年龄60~80岁。均予以规范化治疗并统计治疗结果,绘制Kaplan-Meier曲线分析生存情况;先行单因素分析不同分层条件下患者的总生存期(OS),再将有差异变量纳入COX回归模型,分析肺癌恶性胸腔积液老年患者预后的影响因素。结果:肺癌合并胸腔积液患者80例经治疗后,完全缓解35例、部分缓解28例、无效17例,总有效率为78.75%(63/80),1年OS为31.30%,总OS为20.90%;双肺转移患者中位总生存期(mOS)显著低于无双肺转移患者、合并心包积液患者mOS显著低于无心包积液患者,TKI治疗、胸腔注入"顺铂"药患者mOS显著高于无TKI治疗、未行胸腔注入"顺铂"药患者,且不同局部用药情况、不同胸腔积液控制时间、不同化疗治疗周期患者的mOS比较差异有统计学意义(均P<0.05)。COX回归分析显示,局部未用药治疗、胸腔积液4周未控制、未行化疗治疗是肺癌恶性胸腔积液患者的独立危险因素,TKI治疗、胸腔注入"顺铂"药是预后的保护因素。结论:对肺癌恶性胸腔积液老年,应重视局部治疗,积极控制胸腔积液,胸腔注入"顺铂"药或TKI治疗或可延长生存时间。 Objective:To analyze the influencing factors for the prognosis of elderly patients with malignant pleural effusion of lung cancer.Methods:Eighty patients(aged 60 to 80 years old)with malignant pleural effusion of lung cancer admitted to our hospital between July 2017 and January 2019 were included as the subjects in the study.All patients were given standardized treatment,and the treatment effects were statistically analyzed.Kaplan-Meier curve was plotted to analyze the survival of patients.The overall survival(OS)of patients under different stratification conditions was analyzed through univariate analysis.The variables with differences were included in the COX regression model to analyze the factors affecting elderly patients with malignant pleural effusion of lung cancer.Results:After the treatment,35 of 80 patients with lung cancer and pleural effusion were completely relieved,28 patients were partially relieved,and 17 patients were ineffectively treated.The total effective rate was 78.75%(63/80).The 1-year OS was 31.30%,and the total OS was 20.90%.The median OS(mOS)in patients with double-lung metastasis or pericardial effusion was significantly lower than that in patients without double-lung metastasis or pericardial effusion.The mOS in patients treated with TKI and intrapersonal injection of Cisplatin was significantly higher than that in patients without the TKI treatment and intrapersonal injection of Cisplatin.There were statistically significant differences in mOS between patients with different local medications,different pleural effusion control time,and different chemotherapy cycles(all P<0.05).COX regression analysis showed that untreated local medication,uncontrolled pleural effusion for 4 weeks and nonchemotherapy were independent risk factors for patients with malignant pleural effusion of lung cancer.TKI treatment and intrapersonal injection of Cisplatin were protective factors for the prognosis.Conclusion:For elderly patients with malignant pleural effusion of lung cancer,local treatment should be emphasized,and pleural effusion should be actively controlled.Intrapersonal injection of Cisplatin or TKI treatment may prolong the survival time.
作者 杜璐玲 陈建永 王锋垲 Du Luling;Chen Jianyong;Wang Fengkai(Department of Respiratory Medicine,Chaozhou Municipal Central Hospital,Chaozhou,Guangdong 521000;Department of Oncology,Chaozhou Municipal Central Hospital,Chaozhou,Guangdong 521000,China)
出处 《广州医科大学学报》 2019年第4期6-9,16,共5页 Academic Journal of Guangzhou Medical University
关键词 肺癌恶性胸腔积液 老年 预后 影响因素 malignant pleural effusion of lung cancer elderly prognosis influencing factors
作者简介 通讯作者:陈建永,Email:cjy2944@163.com
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