160例老年小细胞肺癌预后多因素分析

BACKGROUND AND OBJECTIVE: Lung cancer is currently the leading cause of cancer death, two thirds of patients are over the age of 65. Small cell lung cancer (SCLC) accounts for about 15%-20% of all lung cancer. The objective of this study is to evaluate the survival of patients older than 65 with SCLC and analyze the independent prognostic factors in this group of patients. METHODS: A retrospective study has enrolled 160 cases of lung cancer aged over 65. The prognostic factors were analyzed by Kaplan-Meier and Cox multivariate proportional hazards model. RESULTS: ① The median follow-up time was 12 (2-109) months. 1-, 3-, and 5-year survival rate was 47.1%, 13.0%, 9.6% respectively, and 74.4%, 25.0%, 19.7% for limited-stage (LD), and 36.8%, 8.7%, 5.8% for extensive-stage (ED). Median survival time (MST) of all the patients was 12 months, 24 months for LD and 11 months for ED, respectively. ② Multivariate analysis suggested that performance status (PS) pre-treatment, the change of PS after treatment, stage, liver metastases and thoracic radiotherapy were the independent prognostic factors in all patients. ③ For LD-SCLC patients, PS pre-treatment, thoracic radiotherapy were the independent prognostic factors. The model of thoracic radiotherapy (concurrent chemoradiation vs sequential chemoradiation, early concurrent chemoradiation vs late concurrent chemoradiation) and prophylactic cranial irradiation (PCI) did not show significant difference. ④ For ED-SCLC patients, sex, the change of PS after treatment, chemotherapy, liver metastases, thoracic radiotherapy, PCI were the independent prognostic factors. CONCLUSIONS: The survival time is related to PS and thoracic radiotherapy in eldly patients. Besides, it is also related to sex, chemotherapy, liver metastases and PCI for ED-SCLC.