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胸腺瘤当代管理策略的直观评估——印度最大规模经验

Intuitive evaluation of contemporary management strategies in thymoma - the largest Indian experience.

作者信息

Lal Chowdhary Rahul, Chufal Kundan Singh, Ismail Mohammed, Ahmad Irfan, Jwala M, Pahuja Anjali K, Kumar Lalit

机构信息

Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Sir Chotu Ram Marg, New Delhi, India.

Radiation Oncology, Max Super Speciality Hospital Saket, New Delhi, India.

出版信息

Rep Pract Oncol Radiother. 2023 Aug 28;28(4):454-462. doi: 10.5603/RPOR.a2023.0050. eCollection 2023.

Abstract

BACKGROUND

The aim was perusal of the treatment strategies, clinical outcomes and factors impacting these outcomes in thymoma.

MATERIALS AND METHODS

A total of 119 patients diagnosed and treated cases of thymoma, at our hospital, were taken for analysis. Thirty-one patients were excluded due to inadequate medical records. Descriptive statistics were used to report demographic and clinical characteristics. Time period between diagnosis and death was defined as overall survival (OS). Multivariate analysis (MVA), using cox regression modelling, was done by including clinicopathological factors in a bid to identify prognostic factors influencing OS. SPSS version 26 was used for statistical analysis.

RESULTS

The mean age of the patients was 52.17 years and 39 (44.3%), 19 (21.6%), 17 (1.3%) and 13 (4.8%) patients presented with Masaoka stage II, IV, III and I, respectively. Surgery was done in 64 (72.7%) of the patients as a part of the treatment strategy. Radiotherapy was administered to a total of 57 patients with a median dose of 50.4 Gy. Early Masaoka stage at presentation and use of surgery in the treatment plan were statistically significant prognostic factors for a better overall survival on multivariate analysis.

CONCLUSION

Judicious use of radiotherapy and chemotherapy in locally advanced cases may render them resectable. In a bid to gain good survival rates, aggressive multimodality treatment should be offered to the patients.

摘要

背景

目的是研读胸腺瘤的治疗策略、临床结果以及影响这些结果的因素。

材料与方法

选取我院119例已诊断并接受治疗的胸腺瘤病例进行分析。因病历资料不完整排除31例患者。采用描述性统计报告人口统计学和临床特征。诊断至死亡的时间定义为总生存期(OS)。采用多因素分析(MVA),通过Cox回归模型纳入临床病理因素,以确定影响总生存期的预后因素。使用SPSS 26版进行统计分析。

结果

患者的平均年龄为52.17岁,分别有39例(44.3%)、19例(21.6%)、17例(1.3%)和13例(4.8%)患者呈现Masaoka分期II期、IV期、III期和I期。作为治疗策略的一部分,64例(72.7%)患者接受了手术。共有57例患者接受了放疗,中位剂量为50.4 Gy。多因素分析显示,就诊时Masaoka分期较早以及治疗方案中使用手术是总生存期较好的统计学显著预后因素。

结论

在局部晚期病例中明智地使用放疗和化疗可能使它们可切除。为了获得良好的生存率,应给予患者积极的多模式治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aaf7/10547419/f3aa73e07bcb/rpor-28-4-454f1.jpg

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