Concurrent Chemoradiotherapy in Curatively Resected Gallbladder Carcinoma: A Propensity Score-Matched Analysis
Concurrent Chemoradiotherapy in Curatively Resected Gallbladder Carcinoma: A Propensity Score-Matched Analysis
复制标题
根治性切除胆囊癌的同步放化疗：倾向评分匹配分析。
DOI：
10.1016/j.ijrobp.2017.09.029
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发表时间：
2018-01-01
影响因子：
7
通讯作者：
Sun, Xiaonan
中科院分区：
文献类型：
--
作者：
Gu, Benxing;Qian, Liwen;Sun, Xiaonan
目的：比较接受根治性切除术后同时放化疗（S+CCRT）和仅接受根治性切除术（S）的晚期可切除胆囊癌（GBC）患者的总生存期（OS）。方法和材料：2003年6月至2013年7月，94例pT 2 -4、N 0 -1和M0期GBC患者同意纳入临床数据库。接受S+CCRT的患者通过倾向评分与接受S的患者通过最近邻匹配进行匹配，卡尺宽度为0.2，以确保各组之间的基线特征相似。采用Kaplan-Meier分析CCRT对OS和无病生存期（DFS）的影响。对整个队列进行考克斯比例风险回归。结果：78例GBC患者（39例S+CCRT; 39例S）根据倾向评分进行匹配; S+CCRT组的1年、3年和5年OS分别为74.4%、56.4%和42.4%，S组为51.3%、30.8%和17.9%。中位生存期27个月（四分位距[IQR]，12-58个月），S+CCRT组与13个月（IQR，5-30个月），S组（P=.004），1年和3年DFS分别为59.0%和35.9%，48.7%和13.5%，中位DFS为23个月（IQR，8-57个月）与7个月（IQR，4-23个月）（P=.004）。结论：CCRT显著改善了II-IVA期GBC匹配患者的OS。放射治疗联合单药或双药化疗是可行的，耐受性良好。(C)2017爱思唯尔公司All rights reserved.
Purpose: To compare overall survival (OS) between patients receiving radical resection followed by concurrent chemoradiotherapy (S+CCRT) and patients receiving radical resection only (S) for advanced resectable gallbladder carcinoma (GBC).Methods and Materials: Ninety-four GBC patients with stage pT2-4, N0-1, and M0 consented to inclusion in a clinical database from June 2003 to July 2013. Patients who received S+CCRT were matched by propensity score with those who received S through nearest-neighbor matching, with a caliper width of 0.2 to ensure similar baseline characteristics between each group. The effects of CCRT on OS and disease-free survival (DFS) were evaluated with Kaplan-Meier analysis. Cox proportional hazards regression was performed on the entire cohort. Adverse effects and oncologic outcomes were assessed.Results: Seventy-eight patients with GBC (39 S+CCRT; 39 S) were matched according to propensity score; the 1-year, 3-year, and 5-year OS was 74.4%, 56.4%, and 42.4% for the S+CCRT group and 51.3%, 30.8%, and 17.9% for the S group. The median survival time was 27 months (interquartile range [IQR], 12-58 months) for the S+CCRT group versus 13 months (IQR, 5-30 months) for the S group (P=.004), with the 1-year and 3-year DFS being 59.0% versus 35.9% and 48.7% versus 13.5%, respectively, and the median DFS being 23 months (IQR, 8-57 months) versus 7 months (IQR, 4-23 months) (P=.004).Conclusions: The OS of matched patients with stage II-IVA GBC is significantly improved by CCRT. Radiation therapy combined with single-agent or dual-agent chemotherapy was feasible and well tolerated. (C) 2017 Elsevier Inc. All rights reserved.