一个错失的机会:在T3N0M0非小细胞肺癌中,系统疗法的不足利用
Christina K Bedrosian1, Eric S Kawaguchi2, Li Ding3
1Keck School of Medicine of USC, Los Angeles, California.
The Journal of surgical research
|December 7, 2025
概括
系统治疗改善了非小细胞肺癌 (NSCLC) 患者的生存率,这些患者有大瘤但没有结节扩散. 尽管有好处,但这种治疗在这个人群中仍未得到充分利用.
科学领域:
- 在瘤学瘤学.
- 胸部外科手术 胸部外科手术
- 临床研究 临床研究
背景情况:
- 目前的非小细胞肺癌 (NSCLC) 准则建议系统性治疗瘤>5厘米,无论结节状况如何.
- 这项研究侧重于一个独特的NSCLC队列:大型瘤 (>5厘米),没有转移性或结节性疾病.
研究的目的:
- 评估在切除的NSCLC瘤大于5厘米且无结节干涉的患者中全身治疗的利用率.
- 确定系统治疗与这种特定NSCLC群体的生存结果之间的关联.
主要方法:
- 来自国家癌症数据库 (2010-2019) 的8274名切除的NSCLC瘤 (5-7厘米) 患者的回顾性分析.
- 排除标准包括转移性疾病,结节干扰和R1切除.
- 仅接受全身疗法 (化疗,免疫疗法,向疗法) 和仅接受手术的患者的生存时间的比较.
主要成果:
- 45.8% (3787/8274) 符合条件的患者接受了全身疗法.
- 系统疗法接受者年轻,更有可能是女性,私人保险,在学术中心接受治疗,查尔森并发症指数为0,并患有腺癌.
- 系统治疗 (69.5%) 与单独手术 (54.0%) 的五年生存率明显高,多变量调整后的危险比为0.78 (95% CI:0.72-0.85;P <0.001).
- 不接受全身治疗的主要原因包括"没有计划" (75.1%) 和患者/护理人员拒绝 (16.5%).
结论:
- 系统疗法与局部晚期NSCLC (T3N0M0) 的生存率提高有关,但未得到充分利用.
- 外科医生应该考虑在适当的NSCLC患者中倡导全身疗法,这些患者有大瘤并且没有结节扩散.
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