Shao Feng, Qi Wei, Meng Fu Tao, Qiu Lujun, Huang Qiang
Department of Biliary-Pancreatic Surgery, Anhui Provincial Hospital Affiliated with Anhui Medical University, Hefei, Anhui, People's Republic of China.
Cancer Manag Res. 2018 Jun 13;10:1497-1506. doi: 10.2147/CMAR.S160680. eCollection 2018.
This population-based study evaluated the overall (OS) and cancer-specific survival (CSS) benefit from palliative radiotherapy (RT) in patients with unresectable intrahepatic cholangiocarcinoma (ICC).
We queried The Surveillance, Epidemiology, and End Results (SEER) database for the patients with unresectable ICC diagnosed from 1973 to 2013. Propensity score-matched analysis was performed to reduce the impact of the selection bias between the palliative RT group and the nonpalliative RT group. Kaplan-Meier survival curves were used to estimate the survival outcome before and after propensity score matching. OS and CSS were compared between patients with and without palliative RT using univariate and multivariate Cox proportional hazards regression analyses.
A total of 4,027 of 15,803 patients diagnosed with ICC were included in this study. Of those, 847 (21%) patients underwent palliative RT, whereas 3,180 (79%) did not. In the unmatched population, patients treated with palliative RT had improved OS and CSS relative to those treated without palliative RT (adjusted HR =0.9065, 95% CI =0.8360-0.982, =0.01735) and CSS (adjusted HR =0.8874, 95% CI =0.8160-0.9652, =0.00532). After propensity score matching, palliative RT was associated with a significantly improved OS (adjusted HR =0.8544, 95% CI =0.7722-0.9453, =0.00228) and CSS (adjusted HR =0.8563, 95% CI =0.7711-0.9509, =0.0037).
Palliative RT seems to improve the prognosis of patients with unresectable ICC.
这项基于人群的研究评估了姑息性放疗（RT）对不可切除肝内胆管癌（ICC）患者的总生存期（OS）和癌症特异性生存期（CSS）的益处。
我们在监测、流行病学和最终结果（SEER）数据库中查询了1973年至2013年诊断为不可切除ICC的患者。进行倾向评分匹配分析以减少姑息性放疗组和非姑息性放疗组之间选择偏倚的影响。使用Kaplan-Meier生存曲线估计倾向评分匹配前后的生存结果。使用单变量和多变量Cox比例风险回归分析比较接受和未接受姑息性放疗患者的OS和CSS。
本研究纳入了15803例诊断为ICC的患者中的4027例。其中，847例（21%）患者接受了姑息性放疗，而3180例（79%）患者未接受。在未匹配的人群中，接受姑息性放疗的患者与未接受姑息性放疗的患者相比，OS（调整后HR =0.9065，95%CI =0.8360-0.982，P =0.01735）和CSS（调整后HR =0.8874，95%CI =0.8160-0.9652，P =0.00532）有所改善。倾向评分匹配后，姑息性放疗与显著改善的OS（调整后HR =0.8544，95%CI =0.7722-0.9453，P =0.00228）和CSS（调整后HR =
