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阶段转移和免疫治疗对肺癌生存结果的影响
Parth Patel1, Raja Flores1, Naomi Alpert2
1Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, USA.
概括
早期发现非小细胞肺癌 (NSCLC) 显著提高了近3年的生存率,而免疫疗法提供了较小的生存率. 通过查优先考虑早期诊断对于最大限度地提高患者寿命至关重要.
科学领域:
- 在瘤学瘤学.
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 非小细胞肺癌 (NSCLC) 的死亡率正在比发病率下降得更快.
- 有助于改善生存的因素包括吸烟行为变化,早期检测和新疗法.
- 鉴于资源的限制,量化早期检测与新疗法对NSCLC存活率的影响至关重要.
研究的目的:
- 量化早期诊断和新疗法,特别是免疫疗法对非小细胞肺癌生存结果的独立贡献.
- 为了比较早期检测的生存益处 (I/II阶段与II阶段). 在NSCLC患者的第三阶段) 和免疫治疗.
主要方法:
- 对NSCLC患者的监测,流行病学和最终结果-医疗保险数据的分析.
- 患者被分为第四阶段 (2015年诊断) 和I-III阶段 (2010-2012年诊断) 的患者.
- 多变量考克斯比例危险模型评估了免疫疗法和诊断阶段与生存的关联.
主要成果:
- 免疫疗法显著改善了生存率 (HRadj:0.49),患者的寿命延长了10.7个月.
- 在I/II阶段与III阶段的诊断显著改善了生存率 (HRadj:0.36),平均效益为34个月.
- 潜在的生存增长是巨大的:在IV期免疫疗法下获得22,292人年,在III期转移到I/II期时获得70,833人年.
结论:
- 早期诊断 (I/II阶段) 增加了大约3年的预期寿命,而免疫疗法增加了大约0.5年的预期寿命.
- 早期检测更具成本效益,应该通过增加查来优化.
- 建议优先考虑降低风险和早期检测策略,以最大限度地提高NSCLC患者的生存率.
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