| Objective:Lung cancer is still the most common cause of cancer-related death worldwide.Small cell lung cancer(SCLC)occurs most frequently in smokers,accounting for 10% to 20% of all lung cancer patients,and is one of the most malignant and most aggressive lung cancers.Approximately 70% of patients have been diagnosed with distant metastases,such as brain metastases.SCLC standard treatment is cisplatin or carboplatin combined with etoposide chemotherapy and combined radiotherapy.Although the patient is initially more sensitive to treatment,but the latter is often faced with drug resistance,progress.SCLC survival rate is low,one year survival rate of 40%,5-year survival rate of less than 5%.The median progression-free survival was 6-8 months.This study will be from the gender,age,smoking or not,KPS score,newly diagnosed with hyponatremia,newly diagnosed when the NSE is normal,neutrophils and lymphocyte ratio(NLR),platelet and lymphocyte ratio(PLR),systemic immunoinflammatory index(SII),prognostic index(PNI),treatment mode(chemotherapy alone / chemotherapy combined with radiotherapy),the radiotherapy mode,the timing of radiotherapy,whether PCI,first-line chemotherapy cycle,first-line treatment to analysis the first-line treatment of the overall survival(OS),and then found the prognosis of small cell lung cancer-related factors,thereby extending the survival time of patients to reduce recurrence and metastasis.Methods:Collected in January 2010 to January 2015 at the First Affiliated Hospital of Dalian Medical University Department of Oncology 92 cases of pathology or cytology diagnosed as limited period of SCLC,and no surgical treatment of patients.This group of patients had chemotherapy or chemotherapy combined with radiotherapy.All the patients have the end of survival.Recording gender,age,whether smoking or not,the first diagnosed score of blood Na?NSE?NLR?PLR?SII?PNI,the treatment mode(chemotherapy alone / chemotherapy combined with radiotherapy)?the radiotherapy mode,the timing of radiotherapy,whether PCI,the number of cycles of first-line chemotherapy,the efficacy of first-line treatment.A total of 92 patients were followed up and the patient's OS was recorded on a monthly basis.Single factor survival analysis of Kaplan-Meier in SPSS17.0 software.Log rank test the impact of various factors on survival.Through the Kaplan-Meier survival analysis of the meaningful factors,and then COX regression for multivariate analysis,clearly affect the efficacy of independent prognostic factors.P<0.05 indicates that the difference was statistically significant.Results:1.Forty-two patients were followed up for 4.2-56.37 months.The shortest survival time was 4.2 months and the longest survival time was 56.37 months.The 1-year survival rate was 79.35%(74/92)for all patients.The 2-year overall survival rate was 35.77%(33/92)and the 3-year survival rate was 11.96%(11/92).Median survival time was 18.9 months.2.Kaplan-Meier univariate analysis:(1)Sex: male 65 cases(70.65%);female 27 cases(29.35%),P=0.404.(2)Age: 25 in age 25;(27.17%),67 in 67years(72.83%),P=0.322.(3)smoking: smoking 44 cases(47.83%);non-smoking in 48cases(52.17%),P=0.023.(4)KPS score: ? 80 points in 86 cases(93.48%);<80 points in 6 cases(6.52%),P<0.002.(5)Early diagnosis of blood Na: normal 78 cases(84.78%);decreased in 14 cases(15.22%),P =0.887.(6)NSE in newly diagnosed cases:normal in 49 cases(53.26%);increased in 43 cases(46.74%),P=0.015.(7)NLR:> 2.3646 cases(50%),<2.36 46 cases(50%),P=0.010.(8)when newly diagnosed PLR:>130.30 46 cases(50%);<130.30 46 cases(50%),P=0.070.(50%);<523.34 46 cases(50%),P=0.031.(10)PNI:> 76.15 46 cases(50%),<76.15 46 cases(50%),P=0.026.(11)treatment model: 20 cases of chemotherapy alone(21.74%);radiotherapy combined with 72 cases(78.23%),P=0.007.(12)72 cases(80.56%)of sequential radiotherapy;14 cases(19.44%)of synchronous radiotherapy,P<0.002.(38.89%);midterm radiotherapy(chemotherapy,3,4,4),28 cases(38.89%);advanced radiotherapy(chemotherapy 5,6 cycles)16(38-89%);(22.22%),P<0.002(13)PCI: 16 cases (17.39%)were treated with PCI,76 cases(82.61%)without PCI were P<0.002.(14)first-line chemotherapy cycle number: ? 4 83 cases(90.22%);<4 9 cases(9.78%),P<0.002.(15.4%);remission(SD + PD)in 50 cases(54.35%)P=0.002.3.COX multivariate analysis: KPS score,NLR,PNI,treatment mode,radiotherapy mode,radiotherapy intervention time,PCI,first-line chemotherapy cycle number,first-line chemotherapy after treatment and clinical stage of the prognosis is not closely related to SCLC is independent prognostic factors.Conclusion:1.KPS ? 80 points in basic clinical features,longer survival time of non-smokers,and KPS score is independent prognostic factor.2.The lower the NLR ratio in the newly diagnosed laboratory index,the greater the PNI,the more normal treatment of NSE,the longer survivability of patients with SII,among which NLR and PNI are independent prognostic factors.3.Treatment characteristics in the radiotherapy combined,concurrent radiotherapy,radiotherapy time earlier,line PCI treatment,first-line chemotherapy cycle number ? 4cycles,first-line treatment to achieve remission after the survival of patients longer,are independent prognostic factors. |
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