基于竞争性风险模型和条件生存率的I期肝癌患者的手术和外部辐射之间的预后差异
Rong Chen1, Yanli An2, Muhao Xu2
1Department of Oncology, Zhongda Hospital, Southeast University, Nanjing, Jiangsu Province, China.
PloS one
|March 28, 2024
概括
对于早期的肝癌,手术比外部束辐射疗法 (EBRT) 提供更好的生存结果. 患者需要在手术后3年或EBRT后4年的密切监测.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 手术瘤学手术瘤学
- 辐射瘤学 辐射瘤学
背景情况:
- 早期的肝癌会带来独特的治疗挑战.
- 将手术和放射治疗结果进行比较对于患者的预后至关重要.
研究的目的:
- 为了评估外科手术与外部束辐射疗法 (EBRT) 对I期肝癌的比较有效性.
- 确定影响早期肝癌患者生存的预后因素.
主要方法:
- 利用了SEER数据库 (2010-2015年),其中包括2155名患有AJCC第7期I期肝癌的患者.
- 在1972名手术患者和183名EBRT患者中采用了竞争性风险模型和倾向性得分匹配 (PSM).
- 评估的整体存活率 (OS) 和疾病特异性存活率 (DSS) 与条件生存分析.
主要成果:
- 与EBRT相比,手术证明了I阶段肝癌的更高的生存改善率.
- 多变量分析确定年龄,诊断时间,学年级和治疗作为独立的预后因素.
- 手术生存曲线下降速度较慢,在3年左右稳定,而EBRT曲线在4年内显著下降.
结论:
- 在I期肝癌患者中,手术优于EBRT.
- 建议在手术后3年和EBRT后4年进行密切的随访.
- 这些发现有助于临床医生做出早期肝癌治疗的明智决策.
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