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目的分析女性晚期非小细胞肺癌(NSCLC)患者的临床特点及其与预后的关系。方法收集218例初治女性晚期NSCLC患者的病历资料,随访3年,观察患者的总生存时间(0S)。结果218例患者中,腺癌占78.9%(172/218),中位OS为16个月(95%CI 13.257-18.743)。多因素分析结果显示,一线治疗方案、二线治疗方案与OS明显相关(P<0.05)。亚组分析显示,一线酪氨酸激酶抑制剂(tyrosine kinase inhibitor,TKI)治疗有效率为75.0%,中位OS为16个月;二线TKI有效率为35.9%,中位OS为23个月;老年患者(≥65岁)二线化疗或口服TKI与OS明显相关(P<0.05)。病理类型、肝转移、放疗与否与治疗转归相关。结论女性晚期NSCLC患者以腺癌为主,一线、二线治疗方案效果是女性晚期NSCLC患者的独立预后因素。一线TKI有效率较二线TKI有效率高,但OS无明显差异。老年患者二线化疗或口服TKI均能改善OS。非腺癌、肿瘤负荷大是临床治疗不易获益患者的临床特点。
Objective To analyze the clinical characteristics of women with advanced non-small cell lung cancer (NSCLC) and its relationship with prognosis. Methods The medical records of 218 newly diagnosed female patients with advanced NSCLC were collected and followed up for 3 years. The total survival time (0S) was observed. Results Of 218 patients, adenocarcinoma accounted for 78.9% (172/218) and median OS was 16 months (95% CI 13.257-18.743). Multivariate analysis showed that first-line treatment and second-line treatment were significantly associated with OS (P <0.05). Subgroup analysis showed that the effective rate of first-line tyrosine kinase inhibitor (TKI) treatment was 75.0% and the median OS was 16 months; the second-line TKI was 35.9% and the median OS was 23 months; Elderly patients (≥65 years) second-line chemotherapy or oral TKI was significantly associated with OS (P <0.05). Pathological type, liver metastasis, radiotherapy or not and treatment outcome. Conclusions Adenocarcinoma is the mainstay of female patients with advanced NSCLC. The effect of first-line and second-line treatment is an independent prognostic factor in patients with advanced NSCLC. The first-line TKI is more efficient than the second-line TKI, but there is no significant difference in OS. Second-line chemotherapy in elderly patients or oral TKI can improve the OS. Non-adenocarcinoma, tumor burden is not easy to clinical treatment of patients with clinical features.