| 摘要: |
| ［摘要］ 目的 探讨Ⅳ期肺腺癌患者一线系统治疗联合局部强化治疗的有效性及安全性。方法 回顾性分析2022年1月至2023年6月中国人民解放军总医院收治的152例Ⅳ期肺腺癌患者的临床资料，接受一线系统治疗联合局部强化治疗的74例为A组，仅接受一线系统治疗的78例为B组。主要研究终点为无进展生存期（PFS），次要研究终点为总生存期（OS）及治疗相关不良反应。结果 中位随访时间为30.1个月，总体人群中位PFS为28.0个月，其中A组中位PFS为42.0个月，显著高于B组的20.7个月，差异有统计学意义（P<0.05）。多因素Cox回归分析显示，女性、接受局部强化治疗是患者获得更好PFS预后的保护因素（P<0.05），淋巴结转移（N分期为N1期、N2期、N3期）是促使PFS预后不佳的危险因素（P<0.05）；吸烟史、淋巴结转移（N分期为N1期、N2期、N3期）是OS预后不佳的危险因素（P<0.05），化疗联合免疫治疗是OS预后不佳的危险因素（P<0.05）。结论 Ⅳ期肺腺癌患者一线系统治疗联合局部强化治疗能显著改善患者的PFS，放疗和消融治疗在其中起到关键作用，治疗相关不良反应总体可控。 |
| 关键词: Ⅳ期肺腺癌 一线系统治疗 局部强化治疗 疗效 安全性 |
| DOI：10.3969/j.issn.1674-3806.2024.12.04 |
| 分类号:R 734.2 |
| 基金项目: |
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| Efficacy and safety of first-line systemic therapy combined with local intensive therapy for stage Ⅳ lung adenocarcinoma |
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JIA Yangyang1,2, MAO Yunye1,2, LIN Liyan1,2, WANG Jinliang1
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1.Department of Oncology, Senior Department of Oncology, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, China; 2.Chinese PLA Medical School, Beijing 100853, China
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| Abstract: |
| ［Abstract］ Objective To explore the efficacy and safety of first-line systemic therapy combined with local intensive therapy for stage Ⅳ lung adenocarcinoma patients. Methods The clinical data of 152 patients with stage Ⅳ lung adenocarcinoma who were admitted to Chinese PLA General Hospital from January 2022 to June 2023 were retrospectively analyzed. Seventy-four patients who received first-line systemic therapy combined with local intensive therapy were enrolled as group A, and 78 patients who received first-line systemic therapy alone were enrolled as group B. The primary endpoints were progression-free survival(PFS), and the secondary endpoints were overall survival(OS) and treatment-related adverse events. Results The median follow-up time was 30.1 months, and the median PFS of the overall population was 28.0 months, of which the median PFS of the group A was 42.0 months, and the median PFS of the group A was significantly higher than that of the group B(20.7 months), and the difference was statistically significant(P<0.05). The results of multivariate Cox regression analysis showed that female and local intensive therapy were protective factors for better prognosis of PFS in the patients(P<0.05), while lymph node metastases(N stages of N1, N2 and N3) were risk factors for poor prognosis of PFS(P<0.05), and smoking history and lymph node metastases(N stages of N1, N2 and N3) were risk factors for poor OS prognosis(P<0.05), and chemotherapy combined with immunotherapy was a risk factor for poor OS prognosis(P<0.05). Conclusion First-line systemic therapy combined with local intensive therapy can significantly improve PFS in patients with stage Ⅳ lung adenocarcinoma, in which radiotherapy and ablative therapy play a key role. The adverse events associated with the combination therapy are generally controllable. |
| Key words: Stage Ⅳ lung adenocarcinoma First-line systemic therapy Local intensive therapy Efficacy Safety |
