摘要
目的探讨放化疗在初治不可手术切除的ⅢB期非小细胞肺癌(non-small cell lung cancer,NSCLC)转化治疗中的应用价值。方法选择2004年-2016年美国国家癌症研究所监测、流行病学和最终结果(surveillance,epidemiology,and end results program,SEER)数据库收录的接受放化疗或放化疗后再行手术的4364例ⅢB期NSCLC患者资料纳入研究,根据放疗后是否接受手术治疗分为转化治疗组(n=147例)和放化疗组(n=4217例)。转化治疗组接受放化疗后再行手术治疗,放化疗组接受单独放化疗治疗,分析并比较转化治疗对ⅢB期NSCLC患者预后的影响,同时采用1:2倾向性匹配方法分析两组患者预后情况。结果转化治疗组肿瘤特异性生存、总体生存均明显优于放化疗组,差异有统计学意义(χ^(2)=56.658、57.725,P<0.001);多因素Cox回归分析提示,放化疗组肿瘤特异性死亡风险及总体死亡风险分别是转化治疗组的2.306(95%CI 1.840~2.891,P<0.001)倍、2.168(95%CI 1.760~2.671,P<0.001)倍。1:2倾向性匹配后分析提示,转化治疗组肿瘤特异性生存、总体生存均明显优于放化疗组,差异有统计学意义(χ^(2)=42.281、41.520,P<0.001)。结论放化疗转化治疗后的手术治疗能够明显改善不可切除的ⅢB期NSCLC患者的预后。
Objective To investigate the value of radiochemotherapy in conversion therapy of primary unresectable locally advanced non-small cell lung cancer.Methods The data of 4364 patients with stage ofⅢBnon-small cell lung cancer who received radiotherapy and chemotherapy or reoperation after radiochemotherapy from 2004 to 2016 in the U.S.SEER database were included in the study,including 147 patients who received surgery after radiochemotherapy(conversion therapy group)and 4217 patients who received radiotherapy and chemotherapy alone(radiochemotherapy group).We compared the effects of conversion therapy on the prognosis of patients withⅢBstage non-small cell lung cancer,and analyzed the prognosis of the two groups after 1:2 propensity matching method.Results The cancer specific survival and overall survival in the conversion therapy group were significantly better than those in the radiochemotherapy group(χ^(2)=56.658,57.725,P<0.001).Multivariate Cox regression analysis showed that the cancer specific death risk and overall death risk in the radiochemotherapy group were 2.306(95%CI:1.840~2.891,P<0.001)times and 2.168(95%CI:1.760~2.671,P<0.001)times higher than those in the conversion therapy group respectively.After 1:2 propensity matching analysis,it showed that the cancer specific survival and overall survival in the conversion therapy group were significantly better than those in the radiochemotherapy group(χ^(2)=42.281,41.520,P<0.001).Conclusion The conversion therapy of radiochemotherapy before surgical treatment can significantly improve the prognosis of some patients withⅢB stage non-small cell carcinoma.
作者
万里
蒋超
尤振兵
沈成
胡忠吾
徐克平
田文泽
WAN Li;JIANG Chao;YOU Zhenbing;SHEN cheng;HU Zhongwu;XU keping;TIAN Wenze(Department of Medical Oncology,The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University,Huaian Jiangsu 223300,China;Department of Thoracic Surgery,The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University,Huaian Jiangsu 223300,China)
出处
《转化医学杂志》
2023年第1期22-25,共4页
Translational Medicine Journal
基金
国家自然科学青年基金(81702260)。
关键词
肺癌
非小细胞肺癌
转化治疗
放化疗
Lung cancer
Non-small cell lung cancer(NSCLC)
Conversion therapy
Radiochemotherapy
