• 文献检索
  • 文档翻译
  • 深度研究
  • 学术资讯
  • Suppr Zotero 插件Zotero 插件
  • 邀请有礼
  • 套餐&价格
  • 历史记录
应用&插件
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
定价
高级版会员购买积分包购买API积分包
服务
文献检索文档翻译深度研究API 文档MCP 服务
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利：CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2026

文献检索

告别复杂PubMed语法，用中文像聊天一样搜索，搜遍4000万医学文献。AI智能推荐，让科研检索更轻松。

立即免费搜索

文件翻译

保留排版，准确专业，支持PDF/Word/PPT等文件格式，支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述，25分钟生成高质量综述，智能提取关键信息，辅助科研写作。

立即免费体验

在高危老年 I 期非小细胞肺癌的治疗中，肺叶下切除相较于放射治疗可带来更好的治疗效果：一项系统评价和荟萃分析。

Sublobar resection is associated with improved outcomes over radiotherapy in the management of high-risk elderly patients with Stage I non-small cell lung cancer: a systematic review and meta-analysis.

作者信息

Wang Huan-Huan, Zhang Chun-Ze, Zhang Bai-Lin, Chen Jie, Zeng Xian-Liang, Deng Lei, Meng Mao-Bin

机构信息

Department of Radiation Oncology, Tianjin's Clinical Research Center for Cancer and Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin 300060, China.

Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin 300121, China.

出版信息

Oncotarget. 2017 Jan 24;8(4):6033-6042. doi: 10.18632/oncotarget.14010.

DOI:10.18632/oncotarget.14010
PMID:28002808
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5351610/
Abstract

BACKGROUND AND AIM

A matched-pair comparison was performed to compare the efficacy and safety of sublobar resection versus radiotherapy for high-risk elderly patients with Stage I non-small cell lung cancer (NSCLC).

PATIENTS AND METHODS

We searched the Cochrane Library, MEDLINE, CENTRAL, EMBASE and manual searches. The meta-analysis was performed to compare overall survival, pattern of failure, and toxicity among the homogeneous studies. Subdivided analyses were also performed.

RESULTS

Sixteen studies containing 11540 patients were included in the meta-analysis. Among these studies, 9 were propensity-score matched (PSM) cohort studies, and 7 were cohort studies. Sublobar resection, compared with radiotherapy (either conventional fraction radiation therapy or stereotactic body radiation therapy), significantly improved the overall survival regardless in both PSM and non-PSM analyses (all p < 0.05). However, the difference in the pattern of failure and toxicity were not significant (all p > 0.05).

CONCLUSIONS

Sublobar resection was associated with improved outcomes in high-risk elderly patients with Stage I NSCLC, which supports the need to compare both treatments in large prospective, randomized, controlled clinical trials.

摘要

背景与目的

进行配对比较，以对比肺叶下切除与放射治疗对高危老年Ⅰ期非小细胞肺癌（NSCLC）患者的疗效与安全性。

患者与方法

我们检索了Cochrane图书馆、MEDLINE、CENTRAL、EMBASE并进行了手工检索。进行荟萃分析以比较同类研究中的总生存期、失败模式及毒性。还进行了细分分析。

结果

荟萃分析纳入了16项研究，共11540例患者。其中，9项为倾向评分匹配（PSM）队列研究，7项为队列研究。与放射治疗（传统分割放射治疗或立体定向体部放射治疗）相比，无论在PSM分析还是非PSM分析中，肺叶下切除均显著改善了总生存期（所有p<0.05）。然而，失败模式和毒性方面的差异并不显著（所有p>0.05）。

结论

肺叶下切除与高危老年Ⅰ期NSCLC患者的预后改善相关，这支持有必要在大型前瞻性、随机、对照临床试验中对两种治疗方法进行比较。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b39/5351610/9e2822acde83/oncotarget-08-6033-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b39/5351610/9e2822acde83/oncotarget-08-6033-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b39/5351610/9e2822acde83/oncotarget-08-6033-g001.jpg

相似文献

1
Sublobar resection is associated with improved outcomes over radiotherapy in the management of high-risk elderly patients with Stage I non-small cell lung cancer: a systematic review and meta-analysis.在高危老年 I 期非小细胞肺癌的治疗中，肺叶下切除相较于放射治疗可带来更好的治疗效果：一项系统评价和荟萃分析。
Oncotarget. 2017 Jan 24;8(4):6033-6042. doi: 10.18632/oncotarget.14010.
2
Immunotherapy (excluding checkpoint inhibitors) for stage I to III non-small cell lung cancer treated with surgery or radiotherapy with curative intent.用于经手术或根治性放疗治疗的Ⅰ至Ⅲ期非小细胞肺癌的免疫疗法（不包括检查点抑制剂）。
Cochrane Database Syst Rev. 2017 Dec 16;12(12):CD011300. doi: 10.1002/14651858.CD011300.pub2.
3
Systemic pharmacological treatments for chronic plaque psoriasis: a network meta-analysis.系统性药理学治疗慢性斑块状银屑病：网络荟萃分析。
Cochrane Database Syst Rev. 2021 Apr 19;4(4):CD011535. doi: 10.1002/14651858.CD011535.pub4.
4
Systemic pharmacological treatments for chronic plaque psoriasis: a network meta-analysis.慢性斑块状银屑病的全身药理学治疗：一项网状荟萃分析。
Cochrane Database Syst Rev. 2017 Dec 22;12(12):CD011535. doi: 10.1002/14651858.CD011535.pub2.
5
Systemic treatments for metastatic cutaneous melanoma.转移性皮肤黑色素瘤的全身治疗
Cochrane Database Syst Rev. 2018 Feb 6;2(2):CD011123. doi: 10.1002/14651858.CD011123.pub2.
6
Surgery for limited-stage small-cell lung cancer.局限期小细胞肺癌的手术治疗
Cochrane Database Syst Rev. 2017 Apr 21;4(4):CD011917. doi: 10.1002/14651858.CD011917.pub2.
7
Immunotherapy (excluding checkpoint inhibitors) for stage I to III non-small cell lung cancer treated with surgery or radiotherapy with curative intent.手术或放疗根治性治疗的 I 期至 III 期非小细胞肺癌的免疫治疗（不包括检查点抑制剂）。
Cochrane Database Syst Rev. 2021 Dec 6;12(12):CD011300. doi: 10.1002/14651858.CD011300.pub3.
8
Ablative and non-surgical therapies for early and very early hepatocellular carcinoma: a systematic review and network meta-analysis.早期和极早期肝细胞癌的消融和非手术治疗：系统评价和网络荟萃分析。
Health Technol Assess. 2023 Dec;27(29):1-172. doi: 10.3310/GK5221.
9
Radical radiotherapy for stage I/II non-small cell lung cancer in patients not sufficiently fit for or declining surgery (medically inoperable).对于不适合或拒绝手术（医学上无法手术）的I/II期非小细胞肺癌患者进行根治性放疗。
Cochrane Database Syst Rev. 2001(1):CD002935. doi: 10.1002/14651858.CD002935.
10
Radical radiotherapy for stage I/II non-small cell lung cancer in patients not sufficiently fit for or declining surgery (medically inoperable).对于不适合或拒绝手术（医学上无法手术）的Ⅰ/Ⅱ期非小细胞肺癌患者进行根治性放疗。
Cochrane Database Syst Rev. 2001(2):CD002935. doi: 10.1002/14651858.CD002935.

引用本文的文献

1
Surgical consensus for screening, diagnosis, staging, multimodal management and surveillance of early-stage resectable non-small cell lung cancer (NSCLC) in Malaysia.马来西亚早期可切除非小细胞肺癌（NSCLC）筛查、诊断、分期、多模式管理及监测的外科共识
Transl Lung Cancer Res. 2025 Jul 31;14(7):2403-2426. doi: 10.21037/tlcr-2025-296. Epub 2025 Jul 28.
2
Homecare After Cancer Surgery for Older Adults: Derivation and Validation of a Predictive Tool.老年癌症患者术后居家护理：预测工具的推导与验证
Ann Surg Oncol. 2025 Jul 24. doi: 10.1245/s10434-025-17824-6.
3
Sublobar Resection versus Stereotactic Body Radiation Therapy for Clinical Stage I Non-Small Cell Lung Cancer: A Study Using Data from the Korean Nationwide Lung Cancer Registry.

本文引用的文献

1
Long term survival with stereotactic ablative radiotherapy (SABR) versus thoracoscopic sublobar lung resection in elderly people: national population based study with propensity matched comparative analysis.老年人立体定向消融放疗（SABR）与胸腔镜肺叶下切除术的长期生存情况：基于全国人口的倾向匹配比较分析研究
BMJ. 2016 Jul 8;354:i3570. doi: 10.1136/bmj.i3570.
2
Elderly patients undergoing SBRT for inoperable early-stage NSCLC achieve similar outcomes to younger patients.接受立体定向体部放疗（SBRT）的老年不可手术早期非小细胞肺癌（NSCLC）患者与年轻患者的治疗效果相似。
Lung Cancer. 2016 Jul;97:22-7. doi: 10.1016/j.lungcan.2016.04.011. Epub 2016 Apr 19.
3
亚肺叶切除术与立体定向体部放疗治疗Ⅰ期非小细胞肺癌：一项基于韩国全国肺癌登记处数据的研究。
Cancer Res Treat. 2023 Oct;55(4):1171-1180. doi: 10.4143/crt.2022.1581. Epub 2023 Apr 17.
4
Chronic Obstructive Pulmonary Disease and Lung Cancer: A Review for Clinicians.慢性阻塞性肺疾病与肺癌：临床医生综述
Chronic Obstr Pulm Dis. 2022 Jul 29;9(3):454-476. doi: 10.15326/jcopdf.2022.0296.
5
Research on the application of uniportal video-assisted thoracoscopic segmental resection of the lung in elderly patients with non-small cell lung cancer aged over 65 years.65岁以上老年非小细胞肺癌患者单孔电视胸腔镜肺段切除术的应用研究
Wideochir Inne Tech Maloinwazyjne. 2021 Sep;16(3):571-579. doi: 10.5114/wiitm.2021.106829. Epub 2021 Jun 4.
6
The surgical management of early-stage lung adenocarcinoma: is wedge resection effective?早期肺腺癌的外科治疗：楔形切除术有效吗？
J Thorac Dis. 2021 Apr;13(4):2137-2147. doi: 10.21037/jtd-20-3005.
7
Optimal margins for early stage peripheral lung adenocarcinoma resection.早期外周型肺腺癌切除术的最佳切缘。
BMC Cancer. 2021 May 11;21(1):533. doi: 10.1186/s12885-021-08251-3.
8
Immediate and Long-Term Health Care Support Needs of Older Adults Undergoing Cancer Surgery: A Population-Based Analysis of Postoperative Homecare Utilization.癌症手术老年患者的即时和长期医疗保健支持需求：基于人群的术后家庭护理利用分析。
Ann Surg Oncol. 2021 Mar;28(3):1298-1310. doi: 10.1245/s10434-020-08992-8. Epub 2020 Aug 12.
9
Surgery and stereotactic body radiotherapy for early stage non-small cell lung cancer: review of meta-analyses.早期非小细胞肺癌的手术与立体定向体部放疗：荟萃分析综述
J Thorac Dis. 2019 Aug;11(Suppl 13):S1646-S1652. doi: 10.21037/jtd.2018.10.35.
10
Substantial imbalance that is never eliminated with propensity score matched analyses in comparing surgery to stereotactic body radiotherapy for patients with early-stage non-small cell lung cancer.在对早期非小细胞肺癌患者进行手术与立体定向体部放疗的比较时，倾向评分匹配分析无法消除的显著失衡。
J Thorac Dis. 2019 May;11(Suppl 9):S1415-S1419. doi: 10.21037/jtd.2019.03.11.
Clinical Outcomes in Early-stage NSCLC Treated with Stereotactic Body Radiotherapy Versus Surgical Resection.
立体定向体部放疗与手术切除治疗早期非小细胞肺癌的临床结果
Anticancer Res. 2015 Oct;35(10):5607-14.
4
Treatment Outcomes in Stage I Lung Cancer: A Comparison of Surgery and Stereotactic Body Radiation Therapy.I 期肺癌的治疗结果：手术与立体定向体部放射治疗的比较。
J Thorac Oncol. 2015 Dec;10(12):1776-84. doi: 10.1097/JTO.0000000000000680.
5
Outcomes after Stereotactic Body Radiotherapy versus Limited Resection in Older Patients with Early-Stage Lung Cancer.立体定向体部放疗与有限切除治疗老年早期肺癌的疗效比较
J Thorac Oncol. 2015 Aug;10(8):1201-6. doi: 10.1097/JTO.0000000000000600.
6
Analysis of stereotactic radiation vs. wedge resection vs. wedge resection plus Cesium-131 brachytherapy in early stage lung cancer.立体定向放射治疗与楔形切除术及楔形切除术联合铯-131近距离放射治疗在早期肺癌中的分析。
Brachytherapy. 2015 Sep-Oct;14(5):648-54. doi: 10.1016/j.brachy.2015.04.001. Epub 2015 May 19.
7
Sublobar Resection, Radiofrequency Ablation or Radiotherapy in Stage I Non-Small Cell Lung Cancer.I期非小细胞肺癌的肺叶下切除、射频消融或放射治疗
Respiration. 2015;89(6):550-7. doi: 10.1159/000381555. Epub 2015 Apr 30.
8
Lobectomy, sublobar resection, and stereotactic ablative radiotherapy for early-stage non-small cell lung cancers in the elderly.肺叶切除术、亚肺叶切除术和立体定向消融放疗治疗老年早期非小细胞肺癌。
JAMA Surg. 2014 Dec;149(12):1244-53. doi: 10.1001/jamasurg.2014.556.
9
Comparison of long-term survival outcomes between stereotactic body radiotherapy and sublobar resection for stage I non-small-cell lung cancer in patients at high risk for lobectomy: A propensity score matching analysis.立体定向体部放疗与肺段切除术治疗高危Ⅰ期非小细胞肺癌患者的长期生存结果比较：倾向评分匹配分析。
Eur J Cancer. 2014 Nov;50(17):2932-8. doi: 10.1016/j.ejca.2014.09.006. Epub 2014 Sep 30.
10
A propensity-matched analysis of wedge resection and stereotactic body radiotherapy for early stage lung cancer.早期肺癌楔形切除术与立体定向体部放疗的倾向评分匹配分析。
Ann Thorac Surg. 2014 Oct;98(4):1152-9. doi: 10.1016/j.athoracsur.2014.04.128. Epub 2014 Jul 29.