| Objective: This study is designed to collect the clinical data of patients with lung cancer,to realize the influence of various factors on overall survival(OS)of the patients,to compare the effiency of different treatment regimen and to understand the survival benefit of different treatments.Methods: 334 patients with lung cancer who were in hospital from January 2009 to October 2016 were collected from Shaanxi Provincial People's Hospital.Statistical analysis was conducted by gender,age,smoking history,body mass index and other factors.The effiency of different treatments which included surgery,chemotherapy,radiotherapy,targeted therapy and optimal supportive therapy were compared in lung cancer patients.SPSS22.0 statistical software was used to data processing.Kaplan-Meier method was used to calculate the survival rate and draw the survival curve.The log-rank method was used to check the difference of survival curve.The statistical test level was ?=0.05 and P<0.05 was considered statistically significant.The COX multivariate regression analysis model was used to analyze the survival time of lung cancer patients.The variable which HR>1 was the risk factor that affecte the overall survival.Results: The median survival time(MST)of the 334 patients with lung cancer was 12.1 months(95%CI: 10.7-13.2 months),and the 1-year survival rate and 2-year survival rates were 48.2% and 20.3%,respectively.(1)The MST of men was 12.4 months(95%CI: 10.6-14.0 months),the MST of women was 15.2 months(95%CI: 11.8-18.2 months),(P=0.742).(2)The MST of the patients who were bellow 60 years old were 12 months(95%CI: 8.4-15.6 months).The MST of the patients who were 60-69 years old were 18.0 months(95%CI: 13.2-22.8 months).The MST of patients who were 70-79 years were 14.0 months(95%CI: 11.9-16.0 months).The MST of patients who were 80 years and older were 11.0 months(95%CI: 7.5-14.5 months),(P=0.028).(3)The MST of the patients who were smoked were 12.0 months(95%CI: 10.1-13.9 months).The MST of the patients who were not smoked were 15.1 months(95%CI: 12.7-17.5 months),(P=0.238).The MST of patients whose smoking index(SI)?200 were 17.0 months(95%CI: 6.4-27.6 months).The MST of patients whose SI between 200-400 were 15.0 months(95%CI: 7.0-22.9 months).The MST of patients whose SI?400 were 12.0 months(95% CI: 10.5-13.5 months),(P=0.434).(4)The MST of patients whose BMI<18.5 Kg/m2 were 12.0 months(95%CI: 9.5-4.5 months).The MST of patients whose 18.5 Kg/m2 ? BMI <23.9 Kg/m2 were 14.0 months(95%CI: 9.3-18.7 months).The MST of patients whose BMI ?24.0 Kg/m2 were 19.1 months(95%CI: 17.1-21.1 months),(P=0.367).(5)The MST of patients whose PS=1 points were 19.6 months(95%CI: 16.0-23.2 months).The MST of patients whose PS=2 points were 14.0 months(95%CI: 12.2-15.7 months).The MST of patients whose PS=3 points were 7.0 months(95%CI: 4.5-9.4 months).The MST of patients whose PS=4 points were 2.3 months(95%CI: 0-5.0 months),(P<0.05).(6)The MST of patients who were in the stage II were 36.0 months(95%CI: 21.6-50.4 months).The MST of patients who were in the stage III were 12.0 months(95%CI: 9.3-14.7 months).The MST of patients who were in the stage IV were 12.1 months(95%CI: 10.7-13.5 months),(P<0.05).(7)The MST of patients who had metastases were 12.1 months(95%CI: 10.7-13.5 months).The MST of patients who had not metastases were 17.0 months(95%CI: 11.9-22.1 months),(P<0.05).(8)The MST of patients with SCLC were 12.5 months(95%CI: 9.9-15.1 months).The MST of patients with adenocarcinoma were 16.0 months(95%CI: 12.2-19.8 months).The MST of patients with squamous were 13.4 months(95%CI: 11.4-15.4 months),(P >0.05).COX regression analysis showed that smoking index,clinical stage,PS score were the independent risk factors which affected the prognosis of patients with lung cancer.Overall data analysis showed that the MST of patients who underwent active antitumor therapy were 16.0 months(95%CI: 13.9-18.0 months),whereas the MST of patients with supportive therapy were 6.4 months(95%CI: 5.0-7.8 months),(P<0.05).The MST of patients with SCLC who only received chemotherapy were 10.0 months(95%CI: 6.4-13.6 months).The MST of patients who received radiotherapy combined with chemotherapy were 14.0 months(95%CI: 11.6-16.4 months).The MST of patients who received surgery combined with chemotherapy were 26.0 months(95% CI: 19.6-32.4 months),(P=0.204).There was no statistically significant difference between the only chemotherapy group and the radiotherapy combined with chemotherapy group(P=0.196).There was also no statistically significant difference between the only chemotherapy group and the surgery combined with chemotherapy group(P=0.167).The MST of patients with NSCLC who only received chemotherapy were 11.0 months(95%CI: 9.6-12.4 months).The MST of patients who received radiotherapy combined with chemotherapy were 13.0 months(95%CI: 7.7-18.3 months).The MST of patients who received surgery combined with chemotherapy were 36.0 months(95%CI: 30.1-41.9 months).The MST of patients who received targeted drug combined with chemotherapy were 14.5 months(95%CI: 10.9-18.0 months),(P<0.05).There was no statistically significant difference between the chemotherapy group and the radiotherapy combined with chemotherapy group(P=0.286).There was statistically significant difference between the chemotherapy group and the surgery combined with chemotherapy group(P<0.05).Besides,the MST of patients with positive genetic mutation who received the targeted drug were 30.8 months(95%CI: 23.6-38.0 months).The MST of patients without genetic mutation who blindly received targeted drug were 12.1 months(95%CI: 7.5-16.7 months),(P<0.05).Conclusion:1.Age,PS score,clinical stage,distant metastasis were important factors which affected OS in patients with lung cancer.Smoking index,PS score and clinical stage were the independent risk factors of OS in patients with lung cancer.2.Positive anti-tumor therapy compared with the supportive therapy significantly improved overall survival in patients with lung cancer.3.Patients with SCLC who received radiotherapy combined with chemotherapy and surgery combined with chemotherapy would extend the overall survival of patients.4.Chemotherapy,surgery,targeted therapy and other individualized treatment could significantly improve the overall survival according to the specific conditions in patients with NSCLC.The patients with NSCLC who received surgery had the longest OS.Clinical benefit was significant in patients who received the targeted therapy,while we needed to choose the appropriate through gene test. |
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