中国完全切除的非小细胞肺癌术后放疗趋势：一项基于医院的多中心10年（2005 - 2014年）回顾性临床流行病学研究
Trends of Postoperative Radiotherapy for Completely Resected Non-small Cell Lung Cancer in China: A Hospital-Based Multicenter 10-Year (2005-2014) Retrospective Clinical Epidemiological Study.
作者信息
Men Yu, Wang Le, Zhang Ye, Gao Shugeng, Li Junling, Wu Ning, Yang Boyan, Liu Shangmei, Ren Jiansong, Huang Yunchao, Wang Debin, Liao Xianzhen, Xing Xiaojng, Du Lingbin, Yang Li, Liu Yuqin, Zhang Yongzhen, Wei Donghua, Liu Yunyong, Zhang Kai, Qiao Youlin, Shi Jufang, Chen Wanqing, Dai Min, Hui Zhouguang
机构信息
Department of VIP Medical Services & Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
出版信息
Front Oncol. 2019 Aug 20;9:786. doi: 10.3389/fonc.2019.00786. eCollection 2019.
The role of postoperative radiotherapy (PORT) in the treatment of patients with completely resected non-small cell lung cancer (NSCLC) is not clear. Few study explored the trends of the PORT use. In this study, we examine the status of PORT use of completely resected NSCLC in mainland China. From 2005 to 2014, patients with primary lung cancer from eight hospitals across seven geographic regions of mainland China were selected. Then patients with staged I-IIIA NSCLC receiving radical surgery were enrolled in this study. The chi-square test was used to compare differences in the use of PORT among the groups of different age, regions and stages. The Cochran-Armitage trend test was used to identify the trend in the PORT use from 2005 to 2014. Totally, 2,253 out of 7,184 patients were with staged I-IIIA NSCLC receiving completely resection. Only 122 patients (5.42%) received PORT. During this decade, the use of PORT declined significantly ( = 0.0002). In high socio-economic areas, the percentage of PORT use was 7.43%, which was significantly higher than 1.34% in the low socio-economic areas ( < 0.0001). Age was also associated with PORT use ( = 0.0747). For N0-1 and N2 NSCLC, the proportions of PORT use were 4.01 and 10.22%, respectively ( < 0.0001). And in N0-1 or N2 NSCLC, the proportions both decreased significantly during this decade ( = 0.009 and 0.026, respectively). For stage I, IIA, IIB and IIIA, the proportions who received PORT were 2.59, 4.65, 5.49, and 10.29%, respectively ( < 0.0001). Modern radiation techniques were widely used, but the volumes and doses varied widely. The proportions of using IMRT and EPID/IGRT increased after 2012. In China, the use of PORT was less than developed countries and had a declined trend. The use of PORT was related to disease stages, patients' age and geographic location. Both in N0-1 and N2 diseases, the use of PORT declined. Proper education of radiation doctors was urgently needed.
术后放疗（PORT）在完全切除的非小细胞肺癌（NSCLC）患者治疗中的作用尚不清楚。很少有研究探讨PORT的使用趋势。在本研究中，我们调查了中国大陆完全切除的NSCLC患者PORT的使用情况。2005年至2014年，选取了中国大陆七个地理区域八家医院的原发性肺癌患者。然后，纳入接受根治性手术的I-IIIA期NSCLC患者。采用卡方检验比较不同年龄、地区和分期组之间PORT使用的差异。采用 Cochr an-Armitage趋势检验确定2005年至2014年PORT使用的趋势。总共7184例患者中有2253例为接受完全切除的I-IIIA期NSCLC患者。只有122例患者（5.42%）接受了PORT。在这十年间，PORT的使用显著下降（ = 0.0002）。在社会经济发达地区，PORT的使用比例为7.43%，显著高于社会经济欠发达地区的1.34%（ < 0.0001）。年龄也与PORT的使用有关（ = 0.0747）。对于N0-1和N2期NSCLC，PORT的使用比例分别为4.01%和10.22%（ < 0.0001）。并且在N0-1或N2期NSCLC中，这十年间PORT的使用比例均显著下降（分别为 = 0.009和0.026）。对于I期、IIA期、IIB期和IIIA期，接受PORT的比例分别为2.59%、4.65%、5.49%和10.29%（ < 0.0001）。现代放疗技术被广泛应用，但照射范围和剂量差异很大。2012年后，调强放疗（IMRT）和电子射野影像装置/图像引导放射治疗（EPID/IGRT）的使用比例增加。在中国，PORT的使用低于发达国家且呈下降趋势。PORT的使用与疾病分期、患者年龄和地理位置有关。在N0-1和N2期疾病中，PORT的使用均有所下降。迫切需要对放疗医生进行适当培训。
Zotero 插件