初次确诊非小细胞肺癌患者首次化疗后骨髓抑制危险因素的前瞻性研究

Risk factors of myelosuppression after initial chemotherapy in patients with initially diagnosed non-small cell lung cancer: a prospective study

摘要:

目的 探讨初次确诊为非小细胞肺癌（non-small cell lung cancer，NSCLC）患者，首次吉西他滨联合顺铂（GP）方案化疗后，在其第1个化疗周期发生骨髓抑制的危险因素。方法 采用前瞻性研究，最终纳入165例初次确诊NSCLC患者，GP方案首次化疗前采用《基线资料调查表》调查其疾病相关因素，每周定期随访其血红蛋白、白细胞、中性粒细胞、血小板情况并记录，随访至第1个化疗周期结束后，根据是否发生骨髓抑制分为未发生骨髓抑制（63例）和骨髓抑制（102例）两组，分析骨髓抑制的危险因素。结果 单因素方差分析显示： 未发生骨髓抑制组与骨髓抑制组年龄、手术、TNM分期、合并症、化疗前血红蛋白、白细胞、中性粒细胞、血小板比较差异有统计学意义（P＜0.05）。Logistic回归分析提示，年龄、TNM分期、合并症、化疗前血红蛋白是骨髓抑制的危险因素（P＜0.05）。结论 年龄、TNM分期、合并症、化疗前血红蛋白是初次确诊NSCLC首次GP方案化疗后，第1个化疗周期中发生骨髓抑制的独立危险因素。

Abstract:

Objective To analyze the risk factors of myelosuppression in patients with initially diagnosed non-small cell lung cancer(NSCLC) undergoing initial chemotherapy. Methods One hundred and sixty five patients with initially diagnosed NSCLC were prospectively enrolled in the study. All patients received chemotherapy of gemcitabine/cisplatin(GP) regimen. The hemoglobin, white blood cells, neutrophil and platelets were weekly followed-up until the completion of chemotherapy cycles. The risk factors of myelosuppression after initial chemotherapy were analyzed. Results There were 63 cases having no myelosuppression and 102 cases with myelosuppression. There were significant differences in age, surgery, TNM stage, comorbidities, as well as the hemoglobin, leukocytes, neutrophil and platelets levels before chemotherapy between two groups（P＜0.05). Logistic regression analysis showed that age, TNM stage, comorbidities and hemoglobin before chemotherapy were risk factors of myelosuppression（P＜0.05). Conclusion Age, TNM stage, comorbidities and hemoglobin before chemotherapy are independent risk factors of myelosuppression after initial chemotherapy in patients with initially diagnosed Non-small cell lung cancer.