对早期侵袭性乳腺癌治疗方法的比较有效性
Yan Lu1, Rachel J Meadows1, Aaron W Gehr1
1Center for Epidemiology & Healthcare Delivery Research, JPS Health Network, Fort Worth, TX, USA.
Annals of epidemiology
|June 24, 2024
概括
目标试验模拟表明,乳腺保护疗法 (BCT) 和乳腺切除术在早期乳腺癌中提供类似的生存率,与RCT发现一致. 需要进一步的研究和更长的随访,以确认.
科学领域:
- 在瘤学瘤学.
- 临床流行病学 临床流行病学
- 生物统计学 生物统计学
背景情况:
- 随机对照试验 (RCT) 表明乳腺保护疗法 (BCT) 和乳腺切除术在早期乳腺癌中的存活率相似.
- 观察性研究报告了BCT的生存优势,可能是由于偏见.
- 需要协调RCT和观察性研究结果之间的差异,以了解乳腺癌治疗结果.
研究的目的:
- 为了比较BCT对早期乳腺癌的生存效应与乳腺切除术.
- 用目标试验模拟来解决和减轻观察性研究中存在的偏差.
- 为了产生与RCT结果更相似的生存估计,RCT结果.
主要方法:
- 使用机构癌症注册表对目标试验的模拟.
- 包括2011年7月至2017年12月期间被诊断患有早期侵袭性乳腺瘤 (≤5厘米) 的成年女性.
- 克隆,审查和权重技术的应用,以估计死亡率和复发的风险差异 (RDs) 和风险比率 (RRs).
主要成果:
- 该研究包括534例乳腺癌病例,平均年龄为56岁,65%是种族/少数民族.
- 在BCT和乳房切除术之间,所有原因的死亡率的8年风险差异为1.5% (95%CL: -7.0%,9.8%).
- 所有原因的死亡率的8年风险比为1.1 (95%CL:0.57,2.2),复发或死亡率的发现类似.
结论:
- 目标试验模拟可以减轻观察性研究中的选择和不朽时间偏差.
- 在比较BCT和乳腺切除术生存结果时,模拟估计与RCT发现更加一致.
- 需要进行更多的随访期和更多事件的额外研究来验证这些发现.
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