在SBRT或手术后的生存率和复发率在医疗可操作的I期NSCLC中
Michael Snider1, Joseph K Salama2, Matthew Boyer2
1Department of Radiation Oncology, Duke University School of Medicine, Durham, NC, United States.
Lung cancer (Amsterdam, Netherlands)
|October 4, 2024
概括
对于医疗可操作的第一阶段非小细胞肺癌 (NSCLC),手术 (腹腔切除或亚叶切除) 与立体体辐射疗法 (SBRT) 相比,提供更好的生存结果. SBRT与更高的区域复发率有关.
科学领域:
- 胸部外科手术 胸部外科手术
- 辐射瘤学 辐射瘤学
- 肺部医学 肺部医学
背景情况:
- 手术是早期非小细胞肺癌 (NSCLC) 的标准治疗方法.
- 立体性身体辐射疗法 (SBRT) 通常只适用于不适合进行手术的患者.
- 使用退伍军人医疗保健系统 (VAHS) 数据库来比较结果.
研究的目的:
- 为了比较整体存活率 (OS),肺癌特异性存活率 (LCSS),无进展存活率 (PFS) 和复发率.
- 评估SBRT与手术切除 (叶叶切除和亚叶叶切除) 在医疗可操作的第一阶段NSCLC患者中.
- 确定当前的可操作性标准是否足够选择患者接受SBRT.
主要方法:
- 在VAHS中,从2000年至2020年对医疗可操作的I期NSCLC患者 (FEV1/DLCO>60%,查尔森并发症指数0-1) 的回顾性研究.
- 倾向性得分匹配为SBRT,分叶切除术和亚分叶切除术创造了1:1:1的队列.
- 分析了包括OS,LCSS,PFS和复发模式在内的结果.
主要成果:
- 每组分析了103名患者,平均随访时间为7.9年.
- 与分叶切除和分叶切除相比,SBRT与明显更糟糕的OS,LCSS和PFS有关.
- 与SBRT (15.5%) 相比,SBRT的区域复发率较高,而SBRT的区域复发率较高,而SBRT的区域复发率较高,比SBRT (15.5%) 和SBRT (15.5%) 相比,SBRT的区域复发率较高,而SBRT的区域复发率较高.
结论:
- 叶叶切除术和亚叶叶切除术显示,在医学上可操作的第一阶段NSCLC中,OS,LCSS和PFS优于SBRT.
- 在SBRT后区域复发率较高可能导致生存结果较差.
- 单独的肺功能和并发症指数不足以选择患者接受SBRT,这表明需要制定减轻区域复发的策略.
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