治疗开始时间对单一原发性非小细胞肺癌存活率的影响:基于人口的研究
Jun Teng1, Yan Liu1, Junyan Xia2
1Respiratory Disease Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, Beijing, China.
Heliyon
|October 9, 2023
概括
延迟开始治疗会对早期非小细胞肺癌 (NSCLC) 的存活率产生负面影响. 然而,对于晚期的NSCLC,治疗延迟不会显著影响结果,这表明阶段特定的治疗时间启动 (TTI) 门.
科学领域:
- 在瘤学瘤学.
- 癌症研究 癌症研究
- 临床流行病学临床流行病学
背景情况:
- 了解延迟开始治疗对非小细胞肺癌 (NSCLC) 结果的影响对于临床决策至关重要.
- 开始治疗的时间 (TTI) 是影响各种癌症患者生存的关键因素.
研究的目的:
- 研究延迟治疗开始时间 (TTI) 与非小细胞肺癌 (NSCLC) 患者的生存结果之间的关联.
- 确定是否存在特定的TTI值,对NSCLC不同阶段的整体存活率 (OS) 和癌症特异性累积死亡率 (CSCM) 有负面影响.
主要方法:
- 来自监测,流行病学和最终结果数据库的大型NSCLC队列 (80,020名患者) 的分析.
- 利用受限制的立方线来建模TTI和危险比率之间的关系,使用倾向性得分匹配进行平衡的组比较.
- 卡普兰-梅尔分析和竞争风险模型评估了生存差异,主要和补充结果分别是总生存率 (OS) 和癌症特异性累积死亡率 (CSCM).
主要成果:
- 超过一个月的TTI与早期 (I-II) NSCLC的危险比率增加有关.
- 在I阶段肺腺癌 (LUAD) 中,早期TTI与更高的OS相关,而I阶段肺状癌 (LUSC) 则显示较低的CSCM与早期TTI.
- 对于晚期 (II-IV) NSCLC,延迟的TTI并没有显著影响OS或CSCM.
结论:
- 长时间的TTI (≥31天) 仅在I期NSCLC中对OS和CSCM产生负面影响.
- 这些发现表明NSCLC可能存在特定阶段的"安全"TTI值,需要进一步调查和验证.
- 这些结果可以为未来的指导方针提供信息,以优化NSCLC管理中的治疗时间表.
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