摘要
目的:应用倾向指数匹配法均衡组间协变量,评价手术切除合并辅助化疗对治疗局限期小细胞肺癌的疗效。方法:回顾性分析了本院2009年至2014年间诊断为局限期小细胞肺癌的157例住院患者临床资料,其中61例接受手术切除合并辅助化疗,96例接受单纯化疗或放化疗联合治疗。利用倾向指数评分方法,匹配卡钳值0.20,以治疗方式为因变量,以T分期,N分期,病灶数量和病理分型为协变量,均衡不平衡的协变量,模拟出随机化效果,分别对匹配前后的数据进行生存分析。结果:匹配前,手术组和非手术组的中位生存期分别为27个月(95%CI:2.73~51.26)和14个月(95%CI:11.8~16.18)。匹配后,所有协变量分布均达到均衡,比较匹配后两组患者的生存状况,手术组患者的中位生存期为27个月,非手术组中位生存期为17个月(95%CI:13.68~20.32)。Log-rank检验两组生存率具有统计学差异,P=0.001。结论:对于局限期小细胞肺癌患者,如果达到手术切除的临床指证,手术切除合并辅助化疗能使患者的生存获益;在治疗前如能准确诊断为小细胞肺癌的患者,临床分期能指导选择合适的治疗策略。
Objective： To evaluate the therapeutic effects of surgical resection combined with adjuvant chemothera- py in the patients with limited disease small cell lung cancer（ LD-SCLC ） based on propensity score matching. Methods： Between 2009 and 2014, 61 surgical resections and 96 non-operatives were performed on patients with disease limited stage small cell lung cancer in our institute. Pretreatment clinical parameters including T stage, N stage, number of lesions and histology were used for propensity score matching. After pro- pensity score matching, 30 operative patients and 30 non-op- erative patients were selected and compared. Results： The median survival time of operative group was 27 months （95 % CI：2.73 -51.26）, and the other group was lg months（95% CI： 11.8 - 16.18）. After propensity matching, two groups were similar in regards to important variables. The long-term survival time was significant different （27 months vs. 17 months, P = 0. 001 ）. Conclusion： The current propensity score analysis suggests that surgical resection combined with adjuvant chemotherapy can benefit the survival of patients with limited disease small cell lung cancer.
作者
潘辉
胡艺缤
郭志华
张亚雷
殷伟强
张晋昕
Pan Hui Hu Yibin Guo Zhihua Zhang Yalei Yin Weiqiang ZhangJinxin(Research Center for Translational Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China)
出处
《肿瘤预防与治疗》
2017年第2期85-91,共7页
Journal of Cancer Control And Treatment
基金
广东省科技计划项目(编号:2014A020212713)
关键词
倾向指数
局限期小细胞肺癌
生存分析
手术治疗
辅助化疗
Propensity score
Limited disease small cell lung cancer
Survival analysis
Operative
Adjuvant chemotherapy
