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目的回顾分析198例Ⅲb期和Ⅳ期非小细胞肺癌(NSCLC)的预后因素,探讨Ⅲb期和Ⅳ期NSCLC患者的独立预后因素。方法利用Kaplan-Meier、Log-rank及Cox多因素回归模型的统计学方法分析198例Ⅲb/Ⅳ期NSCLC患者的临床资料。结果本研究中患者整体中位生存时间为13.2个月。单因素分析结果显示,KPS评分、TNM分期、化疗方案、化疗周期、近期疗效与预后相关。多因素分析显示,KPS评分、TNM分期、化疗周期是影响预后的独立因素。结论Ⅲb期和Ⅳ期NSCLC的治疗应根据循证医学的原则给予有效的化疗方案和个体化的疗程数,同时应积极改善患者化疗前的体力状况评分,以期取得较好的疗效。
Objective To retrospectively analyze the prognostic factors of 198 cases of stage Ⅲb and Ⅳ non-small cell lung cancer (NSCLC) and explore the independent prognostic factors of stage Ⅲb and Ⅳ NSCLC. Methods The clinical data of 198 patients with stage Ⅲb / Ⅳ NSCLC were analyzed by Kaplan-Meier, Log-rank and Cox multivariate regression analysis. Results The overall median survival in this study was 13.2 months. Univariate analysis showed that KPS score, TNM staging, chemotherapy regimen, chemotherapy cycle and short-term efficacy were related to prognosis. Multivariate analysis showed that KPS score, TNM stage and chemotherapy cycle were independent prognostic factors. Conclusion The treatment of stage Ⅲb and Ⅳ NSCLC should be based on the principles of evidence-based medicine to give effective chemotherapy regimens and the number of individual courses of treatment, and should actively improve the patient’s physical condition before chemotherapy scores in order to achieve better results.