贫血对晚期非小细胞肺癌患者化疗疗效及预后的影响

BACKGROUND AND OBJECTIVE: Cancer-related anemia is the common complication of non-small cell lung cancer (NSCLC), which affects the quality of life (QOL), chemotherapy efficacy and prognosis in patients with NSCLC. In this study, we statistically analysed the incidence of anemia in NSCLC patients before and after chemotherapy and related risk factors, and investigated the impact of anemia on QOL, chemotherapy efficacy and prognosis in patients with NSCLC. METHODS: Clinical data of 140 patients with NSCLC from January 2007 to December 2008 were collected and retrospectively analysed for the changes in hemoglobin levels before and after chemotherapy, the risk factors of anemia, and the relationship with chemotherapy efficacy and prognosis. Application of QOL scale (EORTCQLQ-C30, Chinese version) to evaluate the impact of anemia on QOL in patients with advanced NSCLC. RESULTS: Total 140 cases of NSCLC patients, the incidence of anemia after two cycles of chemotherapy was significantly higher than that before chemotherapy (71.4% vs 47.1%, P < 0.001), and the severity of anemia increased simultaneously with the cycles of chemotherapy. According to univariete and multivariate Logstic regression analysis, age, clinical stage, PS score and albumin levels were closely related to pre-treatment cancer-related anemia. However, multivariate Logistic regression analysis confirmed that only albumin levels was the risk factors of anemia. QOL scores on physical function, symptoms and overall quality of life were significantly different in anemia and nonanemic patients (P < 0.05). Anemia occurred before and after chemotherapy were significantly lower chemotherapy efficacy in patients with advanced NSCLC. Cancer-related anemia obviously impacted on the prognosis of patients, the median survival of cancer-related anemia patients was significantly shorter than those without anemia (7 months vs 13 months, P < 0.001), and the median survival of cancer-related anemia patients before chemotherapy was significantly longer than those with anemia (7 months vs 11 months, P < 0.001). Cox multivariate regression analysis confirmed that anemia, clinical stage, PS score, albumin level were the independent prognostic factors in advanced NSCLC. CONCLUSIONS: NSCLC patients had a higher incidence of anemia, especially the incidence of chemotherapy-related anemia, age, clinical stage, PS score, albumin levels were the risk factors of pre-treatment cancer-related anemia. NSCLC patients with anemia had lower QOL and chemotherapy efficacy, and shorter lifetime. Anemia was an independent prognostic factor in NSCLC patients.