对于IIIA-N2期非小细胞肺癌患者，肺门淋巴结短径缩小率≤20%可能从术后辅助放疗中获益：一项基于大人群的研究。
PLNR≤20% may be a benefit from PORT for patients with IIIA-N2 NSCLC: a large population-based study.
作者信息
Shang Xiaoling, Li Zhenxiang, Lin Jiamao, Wang Haiyong, Wang Zhehai
机构信息
Department of Internal Medicine- Oncology, Shandong Cancer Hospital and Institute, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan 250117, People's Republic of China,
出版信息
Cancer Manag Res. 2018 Sep 17;10:3561-3567. doi: 10.2147/CMAR.S173856. eCollection 2018.
PURPOSE
Our study was to evaluate the influence of positive lymph nodes ratio (PLNR) on survival for patients with pathological stage IIIA-N2 non-small cell lung cancer (NSCLC) after receiving postoperative radiotherapy (PORT).
PATIENTS AND METHODS
The chi-squared test was used to compare the patient baseline characteristics. Cox proportional hazard model was used to analyze the influence of different variables on overall survival (OS). X-tile model was applied to determine the cutoff values of PLNR. Kaplan-Meier method and log-rank test were used to compare survival differences. Based on different cutoff values of PLNR, Cox proportional hazard model was also used to analyze the influence factors on OS.
RESULTS
Multivariate Cox regression analysis showed that PLNR (=0.001) and PORT (HR=1.283; 95% CI 1.154-1.426; <0.001) were significant independent prognostic factors for OS in patients with resected IIIA-N2 NSCLC. The X-tile model was used to screen three different cutoff values including PLNR≤20%, 20%<PLNR≤40%, PLNR>40%. Based on these different cutoff values, we found that patients with PLNR≤20% receiving PORT have a better OS (=0.007). Further multivariable analysis showed that PORT is an independent prognostic factor of OS only for patients with PLNR≤20% (HR=1.328; 95% CI 1.139-1.549; <0.001). PLNR≤20% may be a prognostic factor for patients with IIIA-N2 NSCLC receiving PORT.
目的
我们的研究旨在评估阳性淋巴结比例（PLNR）对接受术后放疗（PORT）的病理分期IIIA-N2期非小细胞肺癌（NSCLC）患者生存的影响。
患者与方法
采用卡方检验比较患者基线特征。使用Cox比例风险模型分析不同变量对总生存期（OS）的影响。应用X-tile模型确定PLNR的截断值。采用Kaplan-Meier法和对数秩检验比较生存差异。基于PLNR的不同截断值，还使用Cox比例风险模型分析OS的影响因素。
结果
多因素Cox回归分析显示，PLNR（=0.001）和PORT（HR=1.283；95%CI 1.154-1.426；<0.001）是接受手术切除的IIIA-N2期NSCLC患者OS的显著独立预后因素。使用X-tile模型筛选出三个不同的截断值，包括PLNR≤20%、20%<PLNR≤40%、PLNR>40%。基于这些不同的截断值，我们发现接受PORT且PLNR≤20%的患者OS更好（=0.007）。进一步的多变量分析显示，PORT仅是PLNR≤20%患者OS的独立预后因素（HR=1.328；95%CI 1.139-1.549；<0.001）。PLNR≤20%可能是接受PORT的IIIA-N2期NSCLC患者的一个预后因素。
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