基于 Surveillance, Epidemiology, and End Results 数据库的 IIIA-N2 期非小细胞肺癌术后放疗的倾向评分匹配分析。
Propensity score-matching analysis of postoperative radiotherapy for stage IIIA-N2 non-small cell lung cancer using the Surveillance, Epidemiology, and End Results database.
机构信息
Department of Thoracic Surgery, First Hospital of Tsinghua University, Beijing, China.
China State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
出版信息
Radiat Oncol. 2017 Jun 13;12(1):96. doi: 10.1186/s13014-017-0836-6.
BACKGROUND
To investigate the effects of postoperative radiotherapy (PORT) on the survival of patients with resected stage IIIA-N2 non-small cell lung cancer (NSCLC).
METHODS
A total of 3,334 patients with resected stage IIIA-N2 NSCLC in 2004 to 2013 were identified in the Surveillance, Epidemiology, and End Results database and stratified according to use of PORT. Propensity score-matching (PSM) methods were used to balance the baseline characteristics of patients who did (n = 744) or did not (n = 744) undergo PORT. Overall survival (OS) and lung cancer-specific survival (LCSS) were compared between these two patient groups.
RESULTS
After PSM, PORT increased OS (hazard ratio, 0.793; p = 0.001) and LCSS (hazard ratio, 0.837; p = 0.022) compared with no PORT. The OS benefit for PORT was mainly seen in patients aged <60 years (5-year OS, 35.4% versus 28.9% for PORT versus no PORT, respectively; p = 0.026) and in those who underwent lobectomy (5-year OS, 43.5% versus 34.5% for PORT versus no PORT, respectively; p = 0.001). The LCSS benefit for PORT was significant in patients undergoing lobectomy (5-year LCSS, 48.3% versus 42.3% for PORT versus no PORT, respectively; p = 0.036).
CONCLUSIONS
The survival benefits of PORT were primarily observed in patients with resected stage IIIA-N2 NSCLC who were <60 years of age or had undergone lobectomy.
背景
研究术后放疗（PORT）对可切除 IIIA-N2 期非小细胞肺癌（NSCLC）患者生存的影响。
方法
从监测、流行病学和最终结果数据库中确定了 2004 年至 2013 年期间 3334 例接受可切除 IIIA-N2 期 NSCLC 治疗的患者，并根据 PORT 的使用情况进行分层。采用倾向评分匹配（PSM）方法平衡接受或不接受 PORT 的患者的基线特征。比较两组患者的总生存（OS）和肺癌特异性生存（LCSS）。
结果
PSM 后，PORT 组 OS（风险比，0.793；p=0.001）和 LCSS（风险比，0.837；p=0.022）较无 PORT 组延长。PORT 的 OS 获益主要见于年龄<60 岁的患者（PORT 组 5 年 OS 率为 35.4%，无 PORT 组为 28.9%；p=0.026）和接受肺叶切除术的患者（PORT 组 5 年 OS 率为 43.5%，无 PORT 组为 34.5%；p=0.001）。PORT 的 LCSS 获益在接受肺叶切除术的患者中具有统计学意义（PORT 组 5 年 LCSS 率为 48.3%，无 PORT 组为 42.3%；p=0.036）。
结论
PORT 的生存获益主要见于年龄<60 岁或接受肺叶切除术的可切除 IIIA-N2 期 NSCLC 患者。
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