中国肿瘤外科杂志2025，Vol.17Issue(2)：130-134,5.DOI:10.3969/j.issn.1674-4136.2025.02.005
新辅助化疗联合免疫疗法对老年晚期肺癌患者疗效及预后分析
Efficacy and prognosis of neoadjuvant chemotherapy combined with immunotherapy in elderly patients with advanced lung cancer
摘要
Abstract
Objective To investigate the clinical efficacy and prognosis of neoadjuvant chemotherapy combined with immunotherapy(NCCI)in elderly patients with advanced lung cancer with medical complications.Methods The clinical data of pathologically diagnosed patients with advanced lung cancer over 65 years old admitted to the geriatric department of 904 Hospital of the Chinese People's Liberation Army Joint Logistic Support Force from January 2021 to August 2023 were collected,and a total of 80 cases were enrolled.Accoding to the treatment plan,the patients were divided into observation group(neoadjuvant chemotherapy)and combination group(neoadjuvant chemotherapy combined with immunotherapy),and the survival were followed,and the relationship between the clinical characteristics and prognosis of age,gender,smoking status,pathological type,treatment mode,charlson comorbidity index(CCI)were analyzed.Kaplan-Meier method was used to analyze the effects of single factors on survival.Log-rank method was used to test and compare the difference of survival time.Cox proportional risk model was used in multivariate analysis.Results Univariate analysis of treatment regimens between the two groups showed that age,smoking history and CCI score related to treatment mode,and difference were significantly statistical(P=0.036,0.029,0.023,respectively),while gender,ECOG score,pathological type and tumor stage not related to treatment mode,had no significant difference(P＞0.05).In the control group,there were 4 cases of PR(10.0%),8 cases of PD(20.0%)and 18 cases of SD(45.0%),and the RR was 10.00%In the combination group,8 cases(20.0%)of PR,21 cases(52.5%)of SD,11 cases(27.5%)of PD,and the RR was 20.0%There was a statistically significant difference in efficacy between the two groups(P=0.027).The median progression-free time(PFS)of the control group and the combination group were 5.4 months and 7.0 months,respectively(P＜0.001).The adverse reactions of the two groups mainly included neutropenia,anemia,thrombocytopenia and nausea and vomiting.There was no significant difference in grade 3～4 adverse reactions between the patients with higher complication index and the lower group(P＞0.05).Survival analysis and Cox regression analysis showed that age,treatment regimen and CCI were independent prognostic factors for progression-free survival of lung cancer patients.Conclusions Age,treatment,comorbidities and other factors affect the prognosis and survival of elderly patients with NSCLC.The use of CCI can predict the prognosis of elderly patients with advanced lung cancer by different treatment methods,provide a more comprehensive and powerful reference for clinical decision-makers,and prolong the survival of elderly lung cancer patients.关键词
晚期肺癌/新辅助化疗/老年/内科并发症/疗效Key words
Advanced lung cancer/Neoadjuvant chemotherapy/Old age/Medical complications/Therapeutic effect引用本文复制引用
单燕,陆秋英,徐亚萍,高妍芬..新辅助化疗联合免疫疗法对老年晚期肺癌患者疗效及预后分析[J].中国肿瘤外科杂志,2025,17(2):130-134,5.基金项目
无锡市科技计划项目(N20192017) （N20192017）
