高级检索

    中性粒细胞减少出现时间与非手术治疗肺鳞癌患者的预后关系

    Relationship between the onset time of neutropenia and the prognosis of patients with lung squamous cell carcinoma after non-surgical treatment

    • 摘要: 目的 探讨中性粒细胞减少出现时间与非手术治疗肺鳞癌患者预后的关系。方法 收集290例非手术治疗肺鳞癌患者的临床资料,使用ROC曲线确定出现中性粒细胞减少时间的最佳界值,据此最佳界值将患者分为早期组(A组)、晚期组(B组)和未出现组(C组)。比较3组患者的临床特征和生存时间,患者预后的影响因素分析采用Cox回归模型行单因素和多因素分析。结果 中性粒细胞减少时间的最佳界值为36 d。接受单纯化疗和同步放化疗的A组患者的中位生存时间分别为23、27个月,明显高于B组16、20个月和C组的11、17个月(P<0.05)。多因素Cox回归分析结果显示,年龄、临床分期、东部肿瘤协作组(ECOG)评分、分化程度、治疗方式、治疗前中性粒细胞/淋巴细胞比值(NLR)是非手术治疗肺鳞癌患者总生存期的独立影响因素。按治疗方式分层分析显示,中性粒细胞减少出现时间在单纯化疗、同期放化疗中显示与患者预后有关,B组患者及C组的死亡风险要高于A组患者(HR=1.816,P<0.05)(HR=3.198,P<0.05)。结论 中性粒细胞减少出现时间是接受单纯化疗、同步放化疗肺鳞癌患者预后的独立影响因素,监测中性粒细胞减少出现时间有助于对单纯化疗、同步放化疗肺鳞癌患者早期进行预后判断,并及时调整化疗剂量,改善患者预后。

       

      Abstract: Objective To investigate the relationship between the onset time of neutropenia and the prognosis of patients with lung squamous cell carcinoma (LSCC) after non-surgical treatment. Methods A total of 290 LSCC patients after non-surgical treatment were enrolled and their clinical data were collected. The ROC curve was used to determine the optimal cutoff value for the occurrence time of neutropenia. According to the optimal cutoff value, the patients were divided into three groups: an early group (group A)and a late stage group (group B) and a non-appearance group (group C). The three groups were compared for their clinical characteristics and survival time, and their prognostic factors were analyzed by Cox regression univariate and multivariate analysis. Results The optimal cutoff value for the onset time of neutropenia was 36 days. The median survival time of patients in group A who received chemotherapy alone and concurrent chemoradiotherapy was 23 and 27 months, respectively, which was significantly higher than those in group B (16 and 20 months) and group C (11 and 17 months) (P<0.05). Multivariate Cox regression analysis showed that age, clinical stage, ECOG score, degree of differentiation, treatment methods, and NLR before treatment were the independent influencing factors for the overall survival of LSCC patients with non-surgical treatment. According to stratified analysis by treatment method, the onset time of neutropenia was related to the prognosis of patients in chemotherapy alone and concurrent chemoradiotherapy, and the risk of death in group B and group C was higher than that in group A (HR=1.816, P=0.017)(HR=3.198, P<0.05). Conclusions The onset time of neutropenia is an independent influencing factor for the prognosis of LSCC patients after chemotherapy alone and concurrent chemoradiotherapy. Monitoring the onset time of neutropenia is helpful to determine the early prognosis of LSCC patients who received chemotherapy alone or concurrent chemoradiotherapy and timely adjust chemotherapy dose to improve patient prognosis.

       

    /

    返回文章
    返回