大理大学学报 ›› 2023, Vol. 8 ›› Issue (8): 64-70.

• 临床医学 • 上一篇    下一篇

A/N2期非小细胞肺癌患者术后放疗的倾向评分匹配分析

吴茂芳,石 汶,肖寿勇,蔡静静,刘曾平,方 红*   

  1. (成都市青白江区人民医院肿瘤放疗科,成都 610300

  • 收稿日期:2022-02-02 修回日期:2022-09-24 出版日期:2023-08-15 发布日期:2023-07-11
  • 通讯作者: 方红,主任医师,E-mail:529398954@qq.com。
  • 作者简介:吴茂芳,主治医师,主要从事肺癌个体化诊疗研究。

Propensity Score Matching Analysis of Postoperative Radiotherapy in Patients with Stage A/N2 Non-Small Cell Lung Carcinoma

Wu Maofang Shi Wen Xiao Shouyong Cai Jingjing Liu Zengping Fang Hong*   

  1. Department of Radiotherapy Oncology Chengdu Qingbaijiang District People's Hospital Chengdu 610300 China

  • Received:2022-02-02 Revised:2022-09-24 Online:2023-08-15 Published:2023-07-11

摘要: 目的:采用倾向评分匹配(PSM)评估术后放疗在ⅢA/N2期非小细胞肺癌(NSCLC)患者中的作用。方法:从SEER数据库中收集外科手术切除联合辅助化疗的ⅢA/N2NSCLC患者1 832例,PSM平衡各变量,采用?2检验比较2组患者的基线特征、Kaplan-Meier曲线评估2组患者的总生存时间(OS)和肺癌特异性生存期(LCSS)、COX回归模型分析预后因素。结果:在1 832例患者中,行术后放疗患者906例(纳入术后放疗组),未行术后放疗患者926例(纳入对照组),2组患者经PSM后其OSLCSS差异无统计学意义(P0.05);单因素COX回归分析结果显示,年龄<65岁、女性、临床分期Ⅰ~Ⅱ期、肿瘤直径≤3 cm是生存预后保护性因素(HR1P0.05);多因素COX回归分析结果显示,年龄<65岁、淋巴结清扫数量≥4个能更好地预测患者的OSLCSSHR1P0.05);在术后放疗亚组中,肺鳞癌和年龄<65岁患者的LCSS更差。结论:手术切除联合辅助化疗的ⅢA/N2NSCLC患者加用术后放疗并不能改善其预后。

关键词: font-family:宋体, ">非小细胞肺癌;Ⅲfont-family:", ">A/N2font-family:宋体, ">期;术后放疗;倾向评分匹配;预后因素

Abstract: Objective Propensity score matchingPSM was used to evaluate the effect of postoperative radiotherapy in patients with stage A/N2 non-small cell lung carcinomaNSCLC. Methods A total of 1 832 patients with stage A/N2 NSCLC undergoing surgical resection combined with adjuvant chemotherapy were collected from the SEER database. Baseline characteristics of the two groups were compared by χ2  test overall survivalOS and lung cancer-specific survivalLCSS of the two groups were evaluated by Kaplan-Meier curve and prognostic factors were analyzed by COX regression model. Results Among the 1 832 patients 906 patients received postoperative radiotherapyincluded in the postoperative radiotherapy group and 926 patients did not receive postoperative radiotherapyincluded in the control group. There was no statistical significance in OS and LCSS between the two groups after PSMP>0.05. Univariate COX regression analysis showed that age<65 years old female clinical stage -Ⅱ, tumor diameter3 cm were protective factors for survival and prognosisHR<1 P<0.05. Multivariate COX regression analysis showed that age<65 years old number of lymph node dissection 4 could better predict OS and LCSSHR<1,P<0.05. In the postoperative radiotherapy subgroup patients with squamous cell carcinoma and age <65 years had worse LCSS. Conclusion The addition of postoperative radiotherapy did not improve the prognosis of stageA/N2 NSCLC patients treated with surgical resection combined with adjuvant chemotherapy.

Key words: font-family:Times New Roman, ">non-small cell lung carcinomafont-family:Times New Roman, ">;font-family:Times New Roman, ">stage font-family:Times New Roman, ">Ⅲfont-family:Times New Roman, ">A/N2font-family:Times New Roman, ">;font-family:Times New Roman, ">postoperative radiotherapyfont-family:Times New Roman, ">;font-family:Times New Roman, ">propensity score matchingfont-family:Times New Roman, ">;font-family:Times New Roman, ">prognostic factors

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