放化疗对手术切除的Ⅰb期非小细胞肺癌患者预后的影响

Effect of radiotherapy and chemotherapy on the prognosis of patients with stageⅠb non-small cell lung cancer undergone surgical resection

目的分析放化疗对手术切除的Ⅰb期非小细胞肺癌(NSCLC)患者预后的影响。方法基于SEER数据库收集2004年至2018年的9155例手术切除的Ⅰb期NSCLC患者临床病理特征和治疗情况,分析放化疗与临床病理特征、总生存期的关系。结果单独化疗是手术切除的Ⅰb期NSCLC患者预后良好的独立预测指标(HR=0.783,P<0.001),而单独放疗或放化联合治疗是预后不良的独立预测指标(HR=1.513,P<0.001;HR=1.838,P<0.001)。接受单独化疗患者的总生存明显高于未接受治疗者,而接受放疗或放化联合治疗患者具有更差的总生存。亚组分析结果一致表明,接受单独化疗患者具有更好的总生存。结论放疗、放化疗及化疗影响手术切除的Ⅰb期NSCLC患者的总生存,对于手术切除的Ⅰb期NSCLC患者建议进行常规的化疗。

Objective To analyze the effect of radiotherapy and chemotherapy on the prognosis of patients stageⅠb non-small cell lung cancer(NSCLC)undergone surgical resection.Methods The clinicopathological characteristics and treatment status of 9155 patients with stageⅠb NSCLC undergone surgical resection were collected from 2004 to 2018 by the SEER database.The correlation between radiotherapy and chemotherapy and clinical characteristics and overall survival were analyzed.Results Chemotherapy alone was an independent predictor of good prognosis for patients with stageⅠb NSCLC undergone surgical resection(HR=0.783,P<0.001),and radiotherapy alone or combined radio-chemotherapy was an independent predictor of poor prognosis for patients(HR=1.513,P<0.001;HR=1.838,P<0.001).The overall survival of patients received postoperative chemotherapy was significantly higher than those received no treatment,while patients received radiotherapy or radio-chemotherapy had worse overall survival.The results of subgroup analysis consistently showed that patients received postoperative chemotherapy had better overall survival.Conclusion Radiotherapy or combined radio-chemotherapy or chemotherapy is related to overall survival in patients with stageⅠb NSCLC undergone surgical resection.Chemotherapy can be routinely recommended for patients with stageⅠb NSCLC undergone surgical resection.