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JTO：非小细胞肺癌患者在大型肿瘤中心放化疗效果更佳

2015-03-12 MedSci MedSci原创

非小细胞肺癌放化疗
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据最新研究报道，III期非小细胞肺癌(NSCLC)患者在拥有丰富经验的治疗中心中进行化疗和放射治疗(CCRT)的总生存期更长，无论该中心是学术或社区癌症中心。肺癌是美国癌症相关死亡的主要原因，每年有224000人新诊断为肺癌，而死于肺癌的则每年有159000人，其中非小细胞肺癌占85%。肺癌的阶段是由肿瘤的大小、淋巴结的转移程度和位置以及肿瘤是否已经发生远处转移决定的。大约四分之一的非小细胞肺癌病

据最新研究报道，III期非小细胞肺癌(NSCLC)患者在拥有丰富经验的治疗中心中进行化疗和放射治疗(CCRT)的总生存期更长，无论该中心是学术或社区癌症中心。

肺癌是美国癌症相关死亡的主要原因，每年有224000人新诊断为肺癌，而死于肺癌的则每年有159000人，其中非小细胞肺癌占85%。肺癌的阶段是由肿瘤的大小、淋巴结的转移程度和位置以及肿瘤是否已经发生远处转移决定的。大约四分之一的非小细胞肺癌病例在诊断时已经到达Ⅲ期，当中只有25%的患者能够存活至少5年。国家综合癌症网络指南支持使用明确CCRT作为Ⅲ期局部晚期NSCLC患者的标准治疗及护理选择。

耶鲁大学医学院的研究人员对国家癌症数据库的数据(NCDB)进行了分析。该数据库来自美国外科学院的癌症委员会和美国癌症协会的联合项目。数据源于2004至2006年间，两单位对明确III期非小细胞肺癌诊断和临床分期的患者进行了CCRT治疗。研究人员试图确定在具备专业治疗大量CCRT病例能力设施的中心进行抗癌治疗与改善总体生存率之间的关系，以及确定是否存在任何病人特征与大容量治疗设施之间的联系。

该项研究结果发表在最新一期国际肺癌研究协会官方杂志——Journal of Thoracic Oncology杂志上。研究指出，小细胞肺癌患者(n = 1207)，选择能够同时处理12个或更大的病例进行CCRT治疗的抗癌中心，相比较少量的中心(n = 8866)能够获得较长的总生存期(19.7 vs 17.3个月，p = 0.02)。同时，在根据病人特点进行调整治疗后，患者的死亡风险显著降低(HR = 0.93，95%置信区间为0.93-0.87，p = 0.03)，这与患者是否在一个学术或非学术中心无关。值得注意的是，在大容量中心治疗的患者有较高的其他疾病(合并症)，肺癌淋巴结转移更多，以及接受更高级的辐射技术处理。

本研究作者指出：“改进的多学科协作，更专业的肿瘤专家，较高的协议遵从性，并且能够在同一治疗中心提供同时的化疗和放射可能是在大容量中心中提高患者生存率的原因。”这项研究的资深作者Henry S. Park博士说：“还需要进一步的研究来确定是否在大型治疗中心中集中放化疗能够提高肺癌生存率同时减少并发症和成本。”

原始出处：


Elyn H. Wang, Charles E. Rutter, Christopher D. Corso, Roy H. Decker, Lynn D. Wilson, Anthony W. Kim, James B. Yu, Henry S. Park. Patients selected for definitive concurrent chemoradiation at high-volume facilities achieve improved survival in stage III non-small cell lung cancer. Journal of Thoracic Oncology, 2015; 1 DOI: 10.1097/JTO.0000000000000519


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    2015-05-22 智智灵药

    #非小细胞#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=2059498, encodeId=f5bb2059498c3, content=<a href='/topic/show?id=2cc599381bd' target=_blank style='color:#2F92EE;'>#非小细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99381, encryptionId=2cc599381bd, topicName=非小细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Fri May 22 18:20:00 CST 2015, time=2015-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1990539, encodeId=4b721990539dc, content=<a href='/topic/show?id=5739822223f' target=_blank style='color:#2F92EE;'>#肺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82222, encryptionId=5739822223f, topicName=肺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f612331, createdName=gds2009, createdTime=Fri Oct 09 07:20:00 CST 2015, time=2015-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18279, encodeId=db30182e9be, content=都去大中心，看病难啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=drhqh240, createdTime=Sat Mar 14 10:09:00 CST 2015, time=2015-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1287870, encodeId=7310128e87061, content=<a href='/topic/show?id=4d185e31825' target=_blank style='color:#2F92EE;'>#放化疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57318, encryptionId=4d185e31825, topicName=放化疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=310e209, createdName=yzh399, createdTime=Sat Mar 14 02:20:00 CST 2015, time=2015-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1600803, encodeId=1e5f16008037f, content=<a href='/topic/show?id=973e99390a4' target=_blank style='color:#2F92EE;'>#非小细胞肺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99390, encryptionId=973e99390a4, topicName=非小细胞肺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2e0218815946, createdName=zxxiang, createdTime=Sat Mar 14 02:20:00 CST 2015, time=2015-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18178, encodeId=56b9181e8bb, content=太多影响因素, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3yz0JbjHQ7nicJU7lHMOu0Itf3Zv3VBzEvK3k4AFPBXhiaxIRNGVI33GicoRXQEjkaasjdlWKwZuwcyhDP9Jibqt5ct/0, createdBy=f1281613275, createdName=zhouanxiu, createdTime=Thu Mar 12 21:44:00 CST 2015, time=2015-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18160, encodeId=f6b91816060, content=是MDT?还是治疗方案更规范?还是患者心理因素对预后影响, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=116.226.177.**, createdTime=Thu Mar 12 16:28:00 CST 2015, time=2015-03-12, status=1, ipAttribution=)]
    2015-10-09 gds2009

    #肺癌患者#

    0

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    2015-03-14 drhqh240

    都去大中心，看病难啊

    0

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    2015-03-14 yzh399

    #放化疗#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2059498, encodeId=f5bb2059498c3, content=<a href='/topic/show?id=2cc599381bd' target=_blank style='color:#2F92EE;'>#非小细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99381, encryptionId=2cc599381bd, topicName=非小细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Fri May 22 18:20:00 CST 2015, time=2015-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1990539, encodeId=4b721990539dc, content=<a href='/topic/show?id=5739822223f' target=_blank style='color:#2F92EE;'>#肺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82222, encryptionId=5739822223f, topicName=肺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f612331, createdName=gds2009, createdTime=Fri Oct 09 07:20:00 CST 2015, time=2015-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18279, encodeId=db30182e9be, content=都去大中心，看病难啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=drhqh240, createdTime=Sat Mar 14 10:09:00 CST 2015, time=2015-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1287870, encodeId=7310128e87061, content=<a href='/topic/show?id=4d185e31825' target=_blank style='color:#2F92EE;'>#放化疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57318, encryptionId=4d185e31825, topicName=放化疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=310e209, createdName=yzh399, createdTime=Sat Mar 14 02:20:00 CST 2015, time=2015-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1600803, encodeId=1e5f16008037f, content=<a href='/topic/show?id=973e99390a4' target=_blank style='color:#2F92EE;'>#非小细胞肺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99390, encryptionId=973e99390a4, topicName=非小细胞肺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2e0218815946, createdName=zxxiang, createdTime=Sat Mar 14 02:20:00 CST 2015, time=2015-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18178, encodeId=56b9181e8bb, content=太多影响因素, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3yz0JbjHQ7nicJU7lHMOu0Itf3Zv3VBzEvK3k4AFPBXhiaxIRNGVI33GicoRXQEjkaasjdlWKwZuwcyhDP9Jibqt5ct/0, createdBy=f1281613275, createdName=zhouanxiu, createdTime=Thu Mar 12 21:44:00 CST 2015, time=2015-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18160, encodeId=f6b91816060, content=是MDT?还是治疗方案更规范?还是患者心理因素对预后影响, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=116.226.177.**, createdTime=Thu Mar 12 16:28:00 CST 2015, time=2015-03-12, status=1, ipAttribution=)]
    2015-03-14 zxxiang

    #非小细胞肺癌患者#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2059498, encodeId=f5bb2059498c3, content=<a href='/topic/show?id=2cc599381bd' target=_blank style='color:#2F92EE;'>#非小细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99381, encryptionId=2cc599381bd, topicName=非小细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Fri May 22 18:20:00 CST 2015, time=2015-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1990539, encodeId=4b721990539dc, content=<a href='/topic/show?id=5739822223f' target=_blank style='color:#2F92EE;'>#肺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82222, encryptionId=5739822223f, topicName=肺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f612331, createdName=gds2009, createdTime=Fri Oct 09 07:20:00 CST 2015, time=2015-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18279, encodeId=db30182e9be, content=都去大中心，看病难啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=drhqh240, createdTime=Sat Mar 14 10:09:00 CST 2015, time=2015-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1287870, encodeId=7310128e87061, content=<a href='/topic/show?id=4d185e31825' target=_blank style='color:#2F92EE;'>#放化疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57318, encryptionId=4d185e31825, topicName=放化疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=310e209, createdName=yzh399, createdTime=Sat Mar 14 02:20:00 CST 2015, time=2015-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1600803, encodeId=1e5f16008037f, content=<a href='/topic/show?id=973e99390a4' target=_blank style='color:#2F92EE;'>#非小细胞肺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99390, encryptionId=973e99390a4, topicName=非小细胞肺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2e0218815946, createdName=zxxiang, createdTime=Sat Mar 14 02:20:00 CST 2015, time=2015-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18178, encodeId=56b9181e8bb, content=太多影响因素, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3yz0JbjHQ7nicJU7lHMOu0Itf3Zv3VBzEvK3k4AFPBXhiaxIRNGVI33GicoRXQEjkaasjdlWKwZuwcyhDP9Jibqt5ct/0, createdBy=f1281613275, createdName=zhouanxiu, createdTime=Thu Mar 12 21:44:00 CST 2015, time=2015-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18160, encodeId=f6b91816060, content=是MDT?还是治疗方案更规范?还是患者心理因素对预后影响, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=116.226.177.**, createdTime=Thu Mar 12 16:28:00 CST 2015, time=2015-03-12, status=1, ipAttribution=)]
    2015-03-12 zhouanxiu

    太多影响因素

    0

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    2015-03-12 116.226.177.**

    是MDT?还是治疗方案更规范?还是患者心理因素对预后影响

    0

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