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背景与目的第三代新药组成的方案在晚期NSCLC一线化疗中使大部分患者能够取得疾病控制(CR+PR+SD),我们进行了本项回顾性分析以探讨一线化疗疾病控制与疾病未控(PD)患者之间生存的差别,以及疾病控制患者有效(CR+PR)和稳定(SD)患者之间生存的差别,明确与患者生存有关的预后因素。方法本项回顾性分析纳入了完成第三代新药组成的铂类或非铂类方案一线化疗的118例IIIB期(伴恶性胸水)/IV期NSCLC患者,一线化疗的疗效按RECIST标准根据影像学结果评价为CR,PR,SD,PD四种情况。结果一线化疗后CR+PR+SD共86例(72.9%)[其中CR2例(1.7%),PR47例(39.8%),SD37例(31.4%)],PD32例(27.1%)。CR+PR+SD和PD患者MST有统计学差别,为17.8月和8.4月(P=0.001)。CR+PR和SD患者MST无统计学差别,为18.1月和15.5月(P=0.917),中位PFS无统计学差别,为7.1月和6.9月(P=0.622)。Cox多因素回归分析显示分期(IIIB期或IV期)、化疗线程(≤3线或≥4线)、一线化疗疾病是否控制是总生存的独立预后因素。结论本研究结果表明,晚期NSCLC患者一线化疗有效和稳定的患者其生存较进展患者好,疾病稳定患者的生存获益与有效患者无明显差别。
BACKGROUND AND OBJECTIVES The third generation of new drug regimens comprised most patients with advanced disease control (CR + PR + SD) in first-line chemotherapy for advanced NSCLC. We conducted this retrospective analysis to investigate uncontrolled disease control and disease in first-line chemotherapy (PD) and survival differences between patients with effective disease control (CR + PR) and stable (SD), and to identify prognostic factors associated with patient survival. METHODS: This retrospective analysis included 118 patients with stage IIIB (patients with malignant pleural effusion) / stage IV NSCLC who completed the first-generation platinum-based or non-platinum regimen consisting of a third-generation new drug. The efficacy of first-line chemotherapy was evaluated according to the RECIST criteria The results were evaluated as CR, PR, SD, PD four cases. Results There were 86 cases (72.9%) of CR + PR + SD after first-line chemotherapy (CR2 cases (1.7%), PR47 cases (39.8%) and SD37 cases (31.4%)] and PD32 cases (27.1%). There was a statistically significant difference in MST between CR + PR + SD and PD patients (17.8 and 8.4 months, P = 0.001). There was no significant difference in MST between CR + PR and SD patients at 18.1 months and 15.5 months (P = 0.917). There was no significant difference in median PFS between 7.1 and 6.9 months (P = 0.622). Cox multivariate regression analysis showed that stage I (stage IIIB or IV), chemotherapy (≤3 or ≥4), and whether first-line chemotherapy disease was an independent prognostic factor for overall survival. Conclusions The results of this study indicate that patients with advanced NSCLC who are effective and stable in first-line chemotherapy have better survival than patients with advanced NSCLC, and there is no significant difference in survival benefit between patients with stable disease and those with effective disease.