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辅助治疗有益于早期小细胞肺癌患者

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楼主 shumufeng
shumufeng
肿瘤综合科

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这个帖子发布于3年零316天前,其中的信息可能已发生改变或有所发展。

Role of Adjuvant Therapy in a Population-Based Cohort of Patients
With Early-Stage Small-Cell Lung Cancer


Purpose


Data on optimal adjuvant therapy after complete resection of
small-cell lung cancer (SCLC) are limited, and in particular, there
have been no studies evaluating the role of adjuvant chemotherapy,
with or without prophylactic cranial irradiation, relative to no
adjuvant therapy for stage T1-2N0M0 SCLC. This National Cancer Data
Base analysis was performed to determine the potential benefits of
adjuvant chemotherapy with and without prophylactic cranial
irradiation in patients who undergo complete resection for early-stage
small-cell lung cancer.


Patients and Methods


Overall survival of patients with pathologic T1-2N0M0 SCLC who
underwent complete resection in the National Cancer Data Base from
2003 to 2011, stratified by adjuvant therapy regimen, was evaluated
using Kaplan-Meier and Cox proportional hazards analysis. Patients
treated with induction therapy and those who died within 30 days of
surgery were excluded from analysis.


Results


Of 1,574 patients who had pT1-2N0M0 SCLC during the study period, 954
patients (61%) underwent complete R0 resection with a 5-year survival
of 47%. Adjuvant therapy was administered to 59% of patients (n =
566), including chemotherapy alone (n = 354), chemoradiation (n = 190,
including 99 patients who underwent cranial irradiation), and
radiation alone (n = 22). Compared with surgery alone, adjuvant
chemotherapy with or without radiation was associated with
significantly improved survival. In addition, multivariable Cox
modeling demonstrated that treatment with adjuvant chemotherapy
(hazard ratio [HR], 0.78; 95% CI, 0.63 to 0.95) or chemotherapy with
radiation directed at the brain (HR, 0.52; 95% CI, 0.36 to 0.75) was
associated with improved survival when compared with no adjuvant therapy.


Conclusion


Patients with pT1-2N0M0 SCLC treated with surgical resection alone
have worse outcomes than those who undergo resection with adjuvant
chemotherapy alone or chemotherapy with cranial irradiation.


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2016-01-27 09:26 浏览 : 659 回复 : 1
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楼主 shumufeng
shumufeng
肿瘤综合科

动态跟踪版信息专员

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Data on optimal adjuvant therapy after complete resection of
small-cell lung cancer (SCLC) are limited, and in particular, there
have been no studies evaluating the role of adjuvant chemotherapy,
with or without prophylactic cranial irradiation, relative to no
adjuvant therapy for stage T1-2N0M0 SCLC. This National Cancer Data
Base analysis was performed to determine the potential benefits of
adjuvant chemotherapy with and without prophylactic cranial
irradiation in patients who undergo complete resection for early-stage
small-cell lung cancer.


有关小细胞肺癌完整切除术后最理想的辅助治疗的资料是有限的,尤其是还没有研究来评价对于T1-2N0M0分期的小细胞肺癌辅助化疗联合或不联合预防性全脑放疗的作用,相对于不做辅助治疗。国家癌症数据基地的分析被用来判断关于早期小细胞肺癌切除术后的患者辅助化疗联合或不联合预防性脑放疗的潜在益处。


从2003到2011年,在国家癌症数据基地中接受完整切除术的病理分型为T1-2N0M0分期的小细胞肺癌的全部幸存者,使用Kaplan-Meier和Cox比例危害分析来评分,按照辅助治疗方案来分层,分析中不包括使用诱导治疗的患者和那些在术后30天内死亡的患者。


Overall survival of patients with pathologic T1-2N0M0 SCLC who
underwent complete resection in the National Cancer Data Base from
2003 to 2011, stratified by adjuvant therapy regimen, was evaluated
using Kaplan-Meier and Cox proportional hazards analysis. Patients
treated with induction therapy and those who died within 30 days of
surgery were excluded from analysis.


Of 1,574 patients who had pT1-2N0M0 SCLC during the study period, 954
patients (61%) underwent complete R0 resection with a 5-year survival
of 47%. Adjuvant therapy was administered to 59% of patients (n =
566), including chemotherapy alone (n = 354), chemoradiation (n = 190,
including 99 patients who underwent cranial irradiation), and
radiation alone (n = 22). Compared with surgery alone, adjuvant
chemotherapy with or without radiation was associated with
significantly improved survival. In addition, multivariable Cox
modeling demonstrated that treatment with adjuvant chemotherapy
(hazard ratio [HR], 0.78; 95% CI, 0.63 to 0.95) or chemotherapy with
radiation directed at the brain (HR, 0.52; 95% CI, 0.36 to 0.75) was
associated with improved survival when compared with no adjuvant therapy.


在研究期间,1574名T1-2N0M0分期的小细胞肺癌患者中,954名患者(61%)接受R0切除术的5年生存率是47%,辅助治疗被用于59%的患者(n=566),包括单纯化疗(n=354),化疗(n=190,包括99名患者做了全脑放疗),单纯放疗(n=22)。相对于单纯手术的患者,辅助化疗联合或不联合放疗对于显著提高生存率是有关联的,另外,多变量COX模型化证明了辅助化疗,或者化疗联合全脑放疗,与没有辅助治疗相比,在提高生存率方面是有关联的。


对于PT1-2N0M0分期的小细胞肺癌患者,单纯外科手术有更糟糕的结果,相比接受手术并且单纯辅助化疗或化疗联合脑放疗的患者。


Patients with pT1-2N0M0 SCLC treated with surgical resection alone
have worse outcomes than those who undergo resection with adjuvant
chemotherapy alone or chemotherapy with cranial irradiation.


辅助治疗有益于早期小细胞肺癌患者


有关小细胞肺癌完整切除术后最理想的辅助治疗的资料是有限的,尤其是还没有研究来评价对于T1-2N0M0分期的小细胞肺癌辅助化疗联合或不联合预防性全脑放疗的作用,相对于不做辅助治疗。国家癌症数据基地的分析被用来判断关于早期小细胞肺癌切除术后的患者辅助化疗联合或不联合预防性脑放疗的潜在益处。


从2003到2011年,在国家癌症数据基地中接受完整切除术的病理分型为T1-2N0M0分期的小细胞肺癌的全部幸存者,使用Kaplan-Meier和Cox比例危害分析来评分,按照辅助治疗方案来分层,分析中不包括使用诱导治疗的患者和那些在术后30天内死亡的患者。


在研究期间,1574名T1-2N0M0分期的小细胞肺癌患者中,954名患者(61%)接受R0切除术的5年生存率是47%,辅助治疗被用于59%的患者(n=566),包括单纯化疗(n=354),化疗(n=190,包括99名患者做了全脑放疗),单纯放疗(n=22)。相对于单纯手术的患者,辅助化疗联合或不联合放疗对于显著提高生存率是有关联的,另外,多变量COX模型化证明了辅助化疗,或者化疗联合全脑放疗,与没有辅助治疗相比,在提高生存率方面是有关联的。


对于PT1-2N0M0分期的小细胞肺癌患者,单纯外科手术有更糟糕的结果,相比接受手术并且单纯辅助化疗或化疗联合脑放疗的患者。


编译: 826


2016-01-27 09:27
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