中国癌症杂志 ›› 2013, Vol. 23 ›› Issue (9): 759-764.doi: 10.3969/j.issn.1007-3969.2013.09.011

• 论著 • 上一篇    下一篇

晚期恶性肿瘤患者生存期影响因素的相关性分析

顾筱莉,成文武   

  1. 复旦大学附属肿瘤医院综合治疗科,复旦大学上海医学院肿瘤学系,上海 200032
  • 出版日期:2013-09-25 发布日期:2014-02-20
  • 通信作者: 成文武 E-mail:cwwxmm@sina.com

Factors influencing survival time of advanced cancer patients who received palliative care

GU Xiao-li,CHENG Wen-wu   

  1. Department of Palliative Care, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
  • Published:2013-09-25 Online:2014-02-20
  • Contact: CHENG Wen-wu E-mail: cwwxmm@sina.com

摘要:

背景与目的:晚期恶性肿瘤的预后判断在肿瘤治疗领域中非常重要,预后判断准确可以帮助临床医师选择相关的治疗。本研究旨在探讨接受姑息治疗的晚期恶性肿瘤患者的生存期相关影响因素,以期更好的指导临床。方法:回顾性分析20073月—20123月复旦大学附属肿瘤医院姑息治疗科271例死亡患者临床资料。应用Kaplan-Meier计算生存期,Log-rank检验差异性,并行Cox模型多因素分析,建立预后指数方程。结果:单因素分析显示7个相关预后因素为:卡氏评分(P<0.001)、呼吸困难(P=0.037)、瞻望(P=0.015)、外周血白细胞计数>11×109/L(P=0.012)、淋巴细胞比例<12%(P=0.030)、乳酸脱氢酶>500 U/L(P<0.001)、血清白蛋白<30 g/L(P=0.001)。其中卡式评分<30、乳酸脱氢酶>500 U/L、血清白蛋白<30 g/L、瞻望为4个独立预后因素。结论:本研究揭示了晚期恶性肿瘤患者的生存期预后相关因素,有利于临床更准确地预测患者的生存期,并提供相关治疗。

关键词: 晚期恶性肿瘤, 危险因素, 生存期

Abstract:

Background and purpose: How to predict the survival length for terminally cancer patients is very important, it will help families and physicians to make decisions. This study aimed to reveal the factors related to the survival time of terminally ill cancer patients who received palliative care in our hospital. Methods: The clinical data of 271 dead patients treated in the Department of Palliative Care, Fudan University Shanghai Cancer Center from Mar. 2007 to Mar. 2012 were analyzed. The Kaplan-Meier method and the log-rank test were used to determine the corresponding factors with survival. Cox regression model was used to examine the independent prognostic factors. Different survival length of groups divided by different prognostic indexes was compared by log-rank test. Results: Seven factors were found to be related with the survival according to univariate analysis. The related factors were Karnofsky performance score (P<0.001), dyspnea (P=0.037), delirium (P=0.015), high white blood cell count (P=0.012), low lymphocyte percentage (P=0.030), high lactate dehydrogenase (P<0.001) and low serum albumin (P=0.001). The multivariate analysis selected four independent factors: Karnofsky performance score<30, high lactate dehydrogenase, low serum albumin and delirium.Conclusion: The study shows the clinical survival prognostics with Chinese characteristics. The combination of the seven factors may be useful but more studies in this area deserve further investigated.  

Key words: Advanced cancer, Risk factors, Survival time