SABR和手术治疗早期NSCLC临床疗效分析

Comparative analysis of clinical efficacy between stereotactic ablative radiotherapy and surgery forearly-stage non-small cell lung cancer

目的 对比立体定向消融放疗（SABR）和手术治疗早期NSCLC的疗效及安全性。方法 回顾分析2012—2016年间河南省肿瘤医院初治且临床资料完整的早期NSCLC患者,共227例,其中SABR组73例,手术组154例。Kaplan-Meier法计算生存率并Logrank检验,χ2检验分析组间基线资料差异。结果 所有患者均完成治疗,SABR组、手术组3年样本量分别为74、155例。SABR组、手术组3年OS率分别为81.9%、78.2%（P=0.603）,3年PFS率分别为66.9%、66.9%（P=0.565）,3年局部区域无进展率分别为84.0%、90.8%（P=0.133）,3年远处无转移率分别为75.4%、69.8%（P=0.095）。结论 SABR与手术治疗早期NSCLC的OS率、PFS率、局部区域无进展率、远处无转移率相近,SABR是不可手术的早期NSCLC患者的可选择治疗方式。

Objective To compare the clinical efficacy and safety between stereotactic ablative radiotherapy （SABR） and surgery in the treatment of early-stage non-small cell lung cancer （NSCLC）. Methods A total of 227 patients who were initially diagnosed with early-stage NSCLC and with complete clinical data admitted to Henan Cancer Hospital between June 2012 and December 2016 were recruited and assigned into the SABR （n=73） and surgery groups （n=154）.Kaplan-Meier method was used to calculate survival rate and survival comparison was performed using the log-rank test. Chi-square test was adopted to compare the baseline data between two groups. Results All patients completed corresponding treatment. The samples of SABR group and operation group were 74 and 155 cases respectively. The 1-year and 3-year overall survival （OS） rates in the SABR and surgery groups were 97.2%, 81.9% and 96.5%, 78.2%（P=0.603）,respectively. The 1-year and 3-year progression-free survival （PFS） rates in the SABR and surgery groups were 90.1%,66.9% and 89.2%,66.9%（P=0.565）,respectively. The 1-year and 3-year locoregional recurrence-free survival rates in the SABR and surgery groups were 92.8%,84.0% and 96.5%,90.8%（P=0.133）,respectively. The 1-year and 3-year distant metastasis-free survival rates in the SABR and surgery groups were 97.2%,75.4% and 89.2%,69.8%（P=0.095）,respectively. Conclusions SABR and surgery yield similar OS,PFS,locoregional recurrence-free and distant metastasis-free survival rates in the treatment of early-stage NSCLC. Therefore, SABR is an alternative treatment for patients with early-stage NSCLC.