在75岁以上的NSCLC患者中,辅助化疗是否有益? 来自回顾性分析的见解
Yohann Vincent1, Faustine Enoch2, Vanessa Pauly3
1Department of Thoracic and Vascular Surgery, Sainte Anne Military Teaching Hospital, Toulon, France; Department of Thoracic Surgery, Hôpital Nord, Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, Marseille, France.
老年肺癌患者 (75岁以上) 的辅助化疗 (ACT) 显示出初始生存益处,在多变量分析中消失了. 瘤学家选择更健康的淋巴结阳性疾病患者进行ACT.
科学领域:
- 在瘤学瘤学.
- 老年医学 老年医学
- 胸部外科手术 胸部外科手术
背景情况:
- 肺癌是全球癌症死亡的主要原因之一.
- 辅助化疗 (ACT) 改善了可切除的非小细胞肺癌 (NSCLC) 的存活率.
- 在老年患者 (75岁以上) 中,ACT的益处尚未得到充分证实.
研究的目的:
- 评估ACT对老年NSCLC患者 (75岁以上) 的益处.
- 在这个人群中确定ACT受益的预测因素.
主要方法:
- 追溯的单中心研究,对129名75岁以上的切除NSCLC的患者进行了回顾性研究.
- 在接受ACT和不接受ACT的患者之间比较生存结果.
- 主要终点:5年死亡率没有复发;次要终点:整体存活率和复发风险因素.
主要成果:
- 36名患者接受了ACT,93人没有. ACT患者年轻,术后疗程更好,淋巴结阳性 (N+) 疾病更多.
- 在单变量分析 (p=0.022) 中,ACT显著降低了5年死亡率,但在多变量分析 (p=0.191) 中没有出现复发.
- 在总生存期观察到类似的趋势,在多变量分析中失去了单变量益处.
结论:
- 瘤学家倾向于为更健康的老年患者提供ACT,特别是那些患有N+疾病的老年患者.
- 在老年NSCLC患者中,ACT是可行的,但它的好处需要仔细考虑竞争的死亡风险.
- 识别高危子组,如N2疾病的子组,对于完善老年人ACT策略至关重要.
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