摘要
目的探讨驱动基因阳性肺腺癌合并骨转移患者的临床特征以及抗肿瘤治疗后骨转移病灶变化情况对预后的影响。方法根据纳入、排除标准获得56例于2017年8月至2023年3月在上海交通大学医学院附属第六人民医院就诊的驱动基因阳性肺腺癌合并骨转移患者的资料,分析其临床、病理及影像学特征,并采用Kaplan-Meier法分析出现成骨型病灶增大或新发成骨型病灶对预后的影响。结果56例患者中,11例(20%)出现病理性骨折,3例(5%)出现脊髓压迫,10例(18%)接受骨转移放疗,9例(16%)接受骨转移手术治疗,上述患者均为溶骨型或混合型骨转移患者。所有人群的中位无进展生存(PFS)期为13.6个月(95%CI为10.3~16.9个月)。20%(11/56)患者出现成骨型病灶增大或新发成骨型病灶,上述患者PFS为37.7个月(95%CI为5.4~70.0个月),无成骨型病灶增大或新发成骨型病灶的患者中位PFS为13.1个月(95%CI为9.3~16.9个月)(χ^(2)=4.141,P=0.0418)。结论驱动基因阳性肺腺癌靶向治疗后出现成骨型病灶增大或新发成骨型病灶患者较未出现上述变化的患者有明显的生存获益。
Objective To investigate the clinical features of patients with driver gene-positive lung adenocarcinoma complicated with bone metastases and the influence of changes in bone metastases on prognosis after antitumor therapy.Methods According to the inclusion and exclusion criteria,the data of 56 patients with driving-gene positive lung adenocarcinoma complicated with bone metastasis admitted to Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from August 2017 to March 2023 were obtained,and their clinical,pathological and imaging characteristics were analyzed.Kaplan-Meier method was used to analyze the effects of enlarged osteogenic lesions or new osteogenic lesions on patients′prognosis.Results Among the 56 patients enrolled,11 patients(20%)had pathological fractures,3 patients(5%)had spinal cord compression,10 patients(18%)received radiotherapy for bone metastases,and 9 patients(16%)received bone metastases surgery.All of these were patients with osteolytic or mixed bone metastases.The median progression-free survival for all patients was 13.6 months(95%CI was 10.3-16.9 months).20%(11/56)patients had enlarged osteogenic lesions or new osteogenic lesions.The median progression-free survival was 37.7 months(95%CI was 5.4-70.0 months)in patients with enlarged osteogenic lesions or new osteogenic lesions,while the median progression-free survival was 13.1 months(95%CI was 9.3-16.9 months)in patients without enlarged osteogenic lesions or new osteogenic lesions(χ^(2)=4.141,P=0.0418).Conclusion The patients with enlarged osteogenic lesions or new osteogenic lesions after targeted therapy of driver gene-positive lung adenocarcinoma have obvious survival benefits compared with patients without enlarged osteogenic lesions or new osteogenic lesions.
作者
周陈亮
王永刚
李洪涛
钱国伟
郑水儿
沈赞
Zhou Chenliang;Wang Yonggang;Li Hongtao;Qian Guowei;Zheng Shuier;Shen Zan(Department of Oncology,Shanghai Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200233,China)
出处
《中华转移性肿瘤杂志》
2023年第4期451-456,共6页
Chinese Journal of Metastatic Cancer
基金
上海交通大学医学院附属第六人民医院回顾性临床研究课题(ynqn202110)。
关键词
肺腺癌
骨转移
预后
Lung adenocarcinoma
Bone metastasis
Prognosis
