基于病理亚型的NSCLC治疗相关心肺病特异性死亡率的时间趋势:基于人口的回顾性队列研究
You Mo1,2, Xinyi Liang2,3, Duncan Wei1
1The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.
Therapeutic advances in medical oncology
|October 6, 2025
概括
在非小细胞肺癌 (NSCLC) 患者,特别是肺腺癌 (LADC) 患者中,心肺疾病的死亡率增加,这与新疗法相吻合. 心血管疾病 (CVD) 死亡率在NSCLC治疗期间需要注意.
科学领域:
- 在瘤学瘤学.
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 公共卫生 公共卫生
背景情况:
- 治疗方面的进步降低了癌症特异性死亡率,但在幸存者中增加了与治疗相关的不良反应 (AE).
- 人们越来越担心癌症幸存者的长期心肺健康状况.
- 了解病理亚型特定的风险对于管理NSCLC患者至关重要.
研究的目的:
- 评估非小细胞肺癌 (NSCLC) 患者心肺疾病特异性死亡率趋势.
- 根据不同的NSCLC病理亚型,分析这些死亡风险.
- 调查新型疗法与心肺死亡率之间的关联.
主要方法:
- 使用监测,流行病学和最终结果 (SEER) 计划和FDA不良事件报告系统 (FAERS) 数据进行回顾性队列研究.
- 用于时间趋势评估的零碎回归分析 (Joinpoint软件).
- 考克斯的比例危险模型用于单变量和多变量死亡风险分析.
主要成果:
- 肺腺癌 (LADC) 患者的整体死亡率下降,但心血管疾病 (CVD) 和肺部疾病特异性死亡率增加 (2012-2016).
- 肺状细胞癌 (LSCC) 患者从免疫疗法启动 (2016-2019) 中获得了好处.
- 免疫检查点阻塞疗法与心血管疾病死亡的增加显著相关 (HR=4.602,p=0.031);内心炎是LADC报告的最高AE.
结论:
- 在NSCLC患者中观察到心肺疾病特异性死亡率的时间增加,与向治疗和免疫治疗的引入相吻合.
- 心血管疾病 (CVD) 特定的死亡风险在NSCLC治疗期间需要特别注意,特别是LADC患者.
- 密切监测心肺性AE对于改善NSCLC幸存者的长期结果至关重要.
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