使用倾向评分匹配法分析根治性切除术后放疗对IIIA-N2期非小细胞肺癌的有益效果。
Beneficial effects of postoperative radiotherapy for IIIA‑N2 non‑small cell lung cancer after radical resection analysed using the propensity score‑matching method.
作者信息
Tian Cuimeng, Liu Guimei, Xu Yongxiang, Xia Guangrong, Zhang Tongmei, Huang Jiaqiang, Liu Fangchao, Li Baolan
机构信息
Department of Radiation Oncology, Beijing Tuberculosis and Thoracic Tumor Research Institute/Beijing Chest Hospital, Capital Medical University, Beijing 101149, P.R. China.
Department of General Medicine, Beijing Tuberculosis and Thoracic Tumor Research Institute/Beijing Chest Hospital, Capital Medical University, Beijing 101149, P.R. China.
出版信息
Oncol Lett. 2023 Apr 5;25(5):205. doi: 10.3892/ol.2023.13791. eCollection 2023 May.
The objective of the present study was to investigate the role of postoperative radiotherapy (PORT) after radical resection of stage IIIA-N2 non-small cell lung cancer (NSCLC). Subgroups of patients who benefited from PORT were evaluated. A retrospective review of 288 consecutive patients with resected pIIIA-N2 NSCLC at Beijing Chest Hospital (Beijing, China) was performed. Of these patients, 61 received PORT. The 288 patients were divided into PORT and non-PORT groups according to the treatment received. The baseline characteristics of the two patient groups were balanced using propensity score-matching (PSM; 1:1 matching). In total, 60 patients in the PORT group and 60 patients in the non-PORT group were matched. After PSM, the median survival time of the matched patients was 53 months. The 1-, 3- and 5-year overall survival (OS) rates of the PORT patient group were 95.0, 63.2 and 48.2%, respectively, while those of the non-PORT group were 86.7, 58.3 and 34.5%, respectively, and there was no significant difference between the two groups (P=0.056). The 5-year local recurrence-free survival (LRFS) rate in the PORT group was significantly improved (P=0.001). The effects of PORT on OS and LRFS rates were analysed in patients with different clinicopathological features. For subgroups with multiple N2 stations, N2 positive lymph nodes ≥4 and squamous cell carcinoma, PORT significantly increased the OS and LRFS rates (P<0.05). In conclusion, there was no statistically significant improvement in the 5-year OS rate with PORT overall, but there may be subgroups, such as patients with multiple N2 stations, N2 positive nodes ≥4 and squamous cell carcinoma histology, that could be explored as potentially benefitting from improved 5-year OS and LRFS rates with PORT.
本研究的目的是探讨术后放疗(PORT)在ⅢA-N2期非小细胞肺癌(NSCLC)根治性切除术后的作用。对从PORT中获益的患者亚组进行了评估。对北京胸科医院(中国北京)连续288例接受pIIIA-N2期NSCLC切除术的患者进行了回顾性分析。这些患者中,61例接受了PORT。根据接受的治疗将288例患者分为PORT组和非PORT组。使用倾向评分匹配(PSM;1:1匹配)使两组患者的基线特征达到平衡。PORT组和非PORT组分别有60例患者进行了匹配。PSM后,匹配患者的中位生存时间为53个月。PORT组患者的1年、3年和5年总生存率(OS)分别为95.0%、63.2%和48.2%,而非PORT组分别为86.7%、58.3%和34.5%,两组之间无显著差异(P = 0.056)。PORT组的5年局部无复发生存率(LRFS)显著提高(P = 0.001)。分析了PORT对不同临床病理特征患者的OS和LRFS率的影响。对于多个N2站、N2阳性淋巴结≥4个和鳞状细胞癌的亚组,PORT显著提高了OS和LRFS率(P < 0.05)。总之,总体而言PORT对5年OS率没有统计学上的显著改善,但可能存在一些亚组,如多个N2站、N2阳性淋巴结≥4个和组织学为鳞状细胞癌的患者,可能从PORT改善的5年OS和LRFS率中获益,值得进一步探索。
相似文献
Zhongguo Fei Ai Za Zhi. 2009-11-20
引用本文的文献
本文引用的文献
Respirology. 2020-11