| Purpose: We analysed the influence of different factors and treatment to overall survival(OS) in 197 elderly patients with lung cancer, to determine which factors can inflence patients’ OS, clear to what kind of treatment can be benefit in elderly patients with lung cancer.Methods: This study retrospect the 197 elderly patients with advanced lung cancer in the Shaanxi Province People’s Hospital from January 2010 to August 2015, according to gender, age, smoking intensity, PS score, tumor stage and distant metastasis to determine which factors can inflence patients’ OS. We also explore the influence of different treatments for elderly lung cancer patients with OS. Use SPSS19.0 to carry out the analysis, survival curves were constructed using the Kaplan-Meier method and differences between survival curves were evaluated by the log-rank test. Differences were considered significant if P<0.05.Results: The Median Survival Time(MST) is 12 months, 1 year Survival rate was58%, 2 year Survival rate is 21%. male patients MST is 16 months, 95% CI is 12.2-19.8months, female patients with median survival time is 19.6 months, 95%CI is 15.8months-23.4 months, P = 0.924, which shows no statistical significance. According to the age MST in 60 ~ 69 aged patients is 34 months,95%CI 19.1 months-48.9 months; 70 ~79 aged patients is 15.8 months, 95%CI 11.6months-19.9 months; MST in the patient beyond 80 years old is in 12 months, 95%CI 8.9months-15.1 months, P < 0.01, the difference is statistical significant among three groups. According to the smoking status MST in never smoking patients is 19 months, 95%CI 15months-22.4 months; MST in the patient which smoking index less than 400 is 36 months, 95%CI, 28.5 months-71.5months, MST in the patient which smoking index more than 400 is 15 months, 95%CI,11.1 months-18.9 months, P = 0.56, no significant among three groups. According to thePS score, MST in the patients with 1 points is 40 months, 95%CI, 27.8 monts-52.2months; MST in the patients with PS score of 2 points is 13 months, 95%CI 10.3months-15.7 months;MST in the patients with PS score of 3 points is 7 months, 95%CI4.0 months-10.0 months, MST in the patients with PS score of 4 points is 1.6 months,95%CI 1.5 months-1.7 months, P < 0.01, have significance between the four. Comparing189 cases according to the tumor stage, the median survival time for patients with stage II was 48 months, 95%CI 27.0 months-69.0 months; Median survival time for patients with stage III was 16 months, 95%CI 13.5 months- 18.3 months; MST for patients with stage IV is 12 months, 95%CI 11.0 months-14.0 months, P < 0.01, have significance between the three. According to distant metastases,The MST of the patients with no distant metastasis is 36 months, 95%CI 23.7 months-48.3 months,The MST of the patients with distant metastasis is 12 months, 95%CI 10.4 months-13.6 months, P < 0.01,have significance between the two comparison.The whole group of patients age, sex,smoking index, PS score, clinical staging multivariate COX regression analysis,regression were conducted step 3, the final model contains three independent variables:smoking index(X3), PS score(X4) and clinical stage(X5) HR > 1, indicating that they are effect in elderly patients with lung cancer risk factor for OS. Under the condition of the same PS grading and clinical staging, smoking index > 400 patients’ risk of death was1.385 times of 400 or less; Smoking in the same case, the strength and the clinical stages PS score every high points, its a 3.607-fold increased risk of death; Under the condition of the same smoking intensity and PS score, clinical stage level, a 1.563-fold increased risk of death.Treatment of patients with different have different OS, patients with symptomatic support treatment whose median survival is 7.0 months, 95%CI 5.5 months-8.5 months,treatment group median survival time is 23.5 months, 95%CI 19.4 months-27.6 months,P < 0.01, have significance between the two comparison. 81 cases of stage III~IV of the elderly patients with lung cancer, the pure chemotherapy patients median survival is17.0 months, 95%CI 11.6 months-22.4 months, Chemotherapy combinedradiotherapy group median survival time is 23.5 months, 95%CI 17.3 months-29.7months, P = 0.149, have no statistical significance between the two group. 50 cases of patients with stage III ~ IV senile non-small cell lung cancer in different total survival of first-line chemotherapy regimens independent sample T test. Three kinds of first-line chemotherapy regimens were more than the west he + cisplatin, pemetrexed plus cisplatin and gemcitabine plus cisplatin. Pemetrexed plus cisplatin group the average survival period is 15.6 months, gemcitabine plus cisplatin group the average survival period of 13.3 months, P = 0.569, have no statistical significance between them. 96 cases of phase III ~ IV in elderly patients with lung cancer, targeted therapy in treatment of patients with MST was 17.0 months, 95%CI 13.1 months-20.9 months; Targeted therapy in treatment of patients with MST is 25.0 months, 95%CI 15.7 months-34.3months, P = 0.048, Comparison between them has statistically significant. 80 patients who underwent chemotherapy or radiotherapy patients and 7 cases of blind patients have targeted drugs compared at the same time, found that two groups overall survival have no significant, P = 0.132, In 14 cases with clear targets for mutations and targeted drugs and 7 cases of routine therapy and blind eat targeted drugs for comparison, overall survival difference has the remarkable significance, P < 0.01.Conclusion: For the elderly lung cancer patients, age, PS score, tumor stage, distant metastasis are independent risk factors influence of the OS,whose PS score and tumor staging is lower, the smaller the age, no patients with distant metastasis, the overall survival significantly longer than other patients. Gender, smoking index of patients with OS had no significant effect. After treatment, patients with active treatment is superior to patients with symptomatic support treatment. Lost the chance of operation phase III ~ IV first-line chemotherapy in patients with difference does not improve the patient’s OS, also combined radiotherapy and chemotherapy can’t prolong the patient’s OS, but at the same time, targeted therapy can obviously prolong the OS, blind to eat OS does little to improve the patients. |
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