完全切除和辅助化疗后术后放疗对高风险pIIIA-N2期非小细胞肺癌患者的作用:一项回顾性队列研究。

IF 2.1 Q3 ONCOLOGY
World Journal of Oncology Pub Date : 2024-04-01 Epub Date: 2024-03-21 DOI:10.14740/wjon1832
Zu Yi Chen, Huan Wei Liang, Yang Liu, Wei Huang, Xin Bin Pan
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引用次数: 0

摘要

研究背景该研究旨在评估在完全切除和辅助化疗后,对pIIIA-N2期非小细胞肺癌(NSCLC)高危患者进行术后放疗的有效性:分析了监测、流行病学和最终结果(SEER)数据库中的 NSCLC 患者数据。研究采用限制性三次样条曲线检验了淋巴结比值(LNR)与癌症特异性生存率(CSS)和总生存率(OS)之间的关系。根据已确定的 LNR 临界值将患者分为高风险组和低风险组,并比较了高风险组中接受术后放疗和未接受放疗患者的生存结果:研究共纳入了 1,690 名患者。CSS和OS的LNR临界值均为0.29。与 LNR < 0.29 的患者相比,LNR ≥ 0.29 的患者 CSS(危险比 (HR) = 1.56,95% 置信区间 (CI):1.37 - 1.78;P < 0.001)和 OS(HR = 1.44,95% CI:1.28 - 1.62;P < 0.001)明显更差。在高风险组(LNR ≥ 0.29)中,术后放疗对 CSS(HR = 0.98,95% CI:0.82 - 1.17;P = 0.809)或 OS(HR = 0.95,95% CI:0.81 - 1.11;P = 0.533)无明显影响:结论:LNR是完全切除和辅助化疗后pIIIA-N2期NSCLC患者的重要预后因素。较高的 LNR(≥ 0.29)与较差的 CSS 和 OS 相关。然而,术后放疗并不能为这些高危患者带来生存益处。我们的研究结果表明,术后放疗不应作为该亚组的常规治疗手段。还需要进一步的研究来探索针对这些患者的有效治疗策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Role of Postoperative Radiotherapy on High-Risk Stage pIIIA-N2 Non-Small Cell Lung Cancer Patients After Complete Resection and Adjuvant Chemotherapy: A Retrospective Cohort Study.

Background: The aim of the study was to assess the effectiveness of postoperative radiotherapy in high-risk patients with stage pIIIA-N2 non-small cell lung cancer (NSCLC) following complete resection and adjuvant chemotherapy.

Methods: Data from NSCLC patients within the Surveillance, Epidemiology, and End Results (SEER) database were analyzed. The study examined the association between lymph node ratio (LNR) and both cancer-specific survival (CSS) and overall survival (OS) using restricted cubic spline curves. Patients were categorized into high- and low-risk groups based on established LNR cut-off values, and survival outcomes were compared between those receiving postoperative radiotherapy and those who did not within the high-risk group.

Results: The study included 1,690 patients. An LNR threshold of 0.29 was identified for both CSS and OS. Patients with an LNR ≥ 0.29 demonstrated significantly worse CSS (hazard ratio (HR) = 1.56, 95% confidence interval (CI): 1.37 - 1.78; P < 0.001) and OS (HR = 1.44, 95% CI: 1.28 - 1.62; P < 0.001) compared to those with an LNR < 0.29. In the high-risk group (LNR ≥ 0.29), postoperative radiotherapy did not significantly affect CSS (HR = 0.98, 95% CI: 0.82 - 1.17; P = 0.809) or OS (HR = 0.95, 95% CI: 0.81 - 1.11; P = 0.533).

Conclusions: LNR is a significant prognostic factor in patients with stage pIIIA-N2 NSCLC post complete resection and adjuvant chemotherapy. A higher LNR (≥ 0.29) is associated with poorer CSS and OS. However, postoperative radiotherapy does not confer survival benefits in these high-risk patients. Our findings suggest that postoperative radiotherapy should not be routinely performed in this subgroup. Further research is required to explore effective treatment strategies for these patients.

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来源期刊
CiteScore
6.10
自引率
15.40%
发文量
37
期刊介绍: World Journal of Oncology, bimonthly, publishes original contributions describing basic research and clinical investigation of cancer, on the cellular, molecular, prevention, diagnosis, therapy and prognosis aspects. The submissions can be basic research or clinical investigation oriented. This journal welcomes those submissions focused on the clinical trials of new treatment modalities for cancer, and those submissions focused on molecular or cellular research of the oncology pathogenesis. Case reports submitted for consideration of publication should explore either a novel genomic event/description or a new safety signal from an oncolytic agent. The areas of interested manuscripts are these disciplines: tumor immunology and immunotherapy; cancer molecular pharmacology and chemotherapy; drug sensitivity and resistance; cancer epidemiology; clinical trials; cancer pathology; radiobiology and radiation oncology; solid tumor oncology; hematological malignancies; surgical oncology; pediatric oncology; molecular oncology and cancer genes; gene therapy; cancer endocrinology; cancer metastasis; prevention and diagnosis of cancer; other cancer related subjects. The types of manuscripts accepted are original article, review, editorial, short communication, case report, letter to the editor, book review.
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