杜佳 1肖何 1许明芳 1孟昊 1岳渝 1谢家印 1王东1
作者信息
- 1. 第三军医大学大坪医院野战外科研究所肿瘤中心,重庆 400042
- 折叠
摘要
Abstract
Objective To describe the clinicopathological features and treatment effect of male patients with lung cancer,and to analyze the factors affecting prognosis to provide reference for and the personalized gradation treatment of male lung cancer.Methods A total of 556 male patients with unoperated lung cancer were retrospective analyzed,including the age,pathological type,EGFR mutations situation,TNM staging,treatment,first-line treatment effect,progression-free survival(PFS) and overall survival(OS).Results The patients aged 35-87 years old,the median age was 60 years old,the average was(60.57±9.82) years old,the majority were 50-69 years old,accounting for 67.81%(377/556).The definite diagnosis pattern was dominated by percutaneous transthoracic needle biopsy and bronchoscopy(84.63%);non-small-cell lung cancer accounted for 77.70%(432/556);adenocarcinoma in pathological types accounted for 38.67%,squamous carcinoma accounted for 32.55%;34 cases were EGFR mutation,accounting for 21.52%(34/158).TNM ⅠA-ⅢA accounted for 26.16%,TNM ⅢB-Ⅳ accounted for 73.84%.Of all cases,32 cases gave up treatment,265 cases underwent only the first-line treatment,184 cases accomplished the second-line treatment,75 cases completed the third-liner/and advanced treatment.There were evaluable 399 cases after the first-line treatment,the objective remission rate(ORR) was 17.79%,and the disease control rate(DCR) was 51.88%.The median PFS was 9 months,the median OS was 14 months.301 cases were followed up for 1 year or more,in which 56 cases died.the 1-year survival rate was 64.12%(193/301),and 2-years survival rate was 18.94%(57/301).ORR of TKI in the first-line treatment was significantly higher than that of chemotherapy and radiotherapy,the difference was statistically significant(P<0.05).The multivariate Cox regression analysis indicated that the objective remission was the independent prognosis factor of PFS;the treatment line number was related with OS,OS of patients receiving the second and third line therapy or more was significantly prolonged,but the age,EGFR mutations,histological type,treatment protocol and effect were not the independent prognostic factors of OS.Conclusion The onset of male lung cancer is dominated by middle-aged and elderly people and non-small-cell lung cancer;in the pathological types,adenocarcinoma and squamous carcinoma have no difference.The EGFR mutation rate is lower.ORR of TKI first-line treatment is significantly higher than that of chemotherapy and radiotherapy.PFS in the patients with objective remission after the first-line treatment is significantly prolonged.The patients receiving more than the second line therapy have better prognosis than that in the patients receiving the first line therapy or the patients without receiving therapy.关键词
肺癌/男性/临床特征/治疗/预后Key words
lung cancer/male/clinical characteristics/treatment/prognosis
