Chhatre Sumedha, Vachani Anil, Allison Ron R, Jayadevappa Ravishankar
Perlman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
Leonard Davis Institute of Health Economics, Perlman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
Cancers (Basel). 2021 Feb 15;13(4):803. doi: 10.3390/cancers13040803.
Data regarding the association between photodynamic therapy (PDT) and mortality in lung cancer patients are limited. We analyzed the association between PDT and mortality in patients with stage III or IV non-small cell lung cancer (NSCLC) using data from the National Cancer Database (NCDB) between 2004 and 2016. From the NCDB, we identified patients receiving laser ablation/cryosurgery or local tumor destruction/excision (which includes PDT). From Medicare and Medicaid claims between 2000 and 2013, we identified NSCLC patients receiving PDT and those receiving bronchoscopy, then used these to confirm the PDT treatment. From NCDB, we extracted NSCLC patients who received radiation with chemotherapy, radiation alone or chemotherapy alone. We used survival analysis to determine the association between PDT and mortality. Between 2004 and 2016, 457,556 NSCLC patients with stage III or stage IV were identified, of which 147 received PDT with radiation and chemotherapy, 227,629 received radiation with chemotherapy, 106,667 had radiation therapy alone and 122,193 received chemotherapy alone. Compared to the radiation alone group, the PDT group and radiation with chemotherapy group had lower hazard of mortality (50% and 53% lower, respectively). Among the NSCLC patients with stage III or stage IV disease, the addition of PDT to radiation therapy offers survival benefit over radiation therapy alone.
关于光动力疗法(PDT)与肺癌患者死亡率之间关联的数据有限。我们利用2004年至2016年国家癌症数据库(NCDB)的数据,分析了III期或IV期非小细胞肺癌(NSCLC)患者中PDT与死亡率之间的关联。从NCDB中,我们确定了接受激光消融/冷冻手术或局部肿瘤破坏/切除(包括PDT)的患者。从2000年至2013年的医疗保险和医疗补助索赔记录中,我们确定了接受PDT的NSCLC患者以及接受支气管镜检查的患者,然后用这些数据来确认PDT治疗情况。从NCDB中,我们提取了接受放疗联合化疗、单纯放疗或单纯化疗的NSCLC患者。我们采用生存分析来确定PDT与死亡率之间的关联。在2004年至2016年期间,共确定了457,556例III期或IV期NSCLC患者,其中147例接受了PDT联合放疗和化疗,227,629例接受了放疗联合化疗,106,667例仅接受放疗,122,193例仅接受化疗。与单纯放疗组相比,PDT组和放疗联合化疗组的死亡风险更低(分别降低了50%和53%)。在III期或IV期NSCLC患者中,放疗联合PDT比单纯放疗具有生存获益。