SABR和手术治疗早期NSCLC临床疗效分析

摘要

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,x2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.