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基于倾向指数匹配法的局限期小细胞肺癌的生存分析
  • ISSN号:1671-6825
  • 期刊名称:《郑州大学学报:医学版》
  • 时间:0
  • 分类:R734.2[医药卫生—肿瘤;医药卫生—临床医学]
  • 作者机构:[1] 潍坊医学院公共卫生学院卫生统计学教研室,潍坊261053, [2] 潍坊医学院财务处,潍坊261053, [3] 山东省肿瘤医院放疗科,济南250117
  • 相关基金:国家自然科学基金项目81141112,81101290;山东省自然科学基金项目ZR2009CM117
中文摘要:

目的:应用倾向指数匹配法均衡组间的协变量,评价单纯应用放疗( CRT )与三维适形放疗联合化疗( CCRT)对局限期小细胞肺癌( LD-SCLC)的治疗效果。方法:LD-SCLC患者224例,其中CRT 109例,CCRT 115例。基线资料包括性别(1=男,0=女)、年龄、吸烟(1=是,2=否)、结核(1=有,2=无)、家族史(1=有,2=无)、TNM分期(1=Ⅰ期,2=Ⅱ期,3=ⅢA期,4=ⅢB期)、血清神经元特异性烯醇化酶(NSE)水平、KPS评分、肿瘤数量(1=单个,2=多个)等。以分组变量为因变量,以协变量为自变量,建立logistic回归模型,计算倾向指数,然后按照倾向指数进行组间卡钳匹配。分别对匹配前后的数据进行生存分析。结果:匹配前CRT组和CCRT组的中位生存期(95%置信区间)分别为2.15(1.96~2.48)和2.37(2.06~2.72) a,1 a生存率分别为82.65%和83.36%,2 a生存率分别为59.02%和64.30%,3 a生存率分别为25.28%和29.34%,两组生存曲线差异无统计学差异(χ2=2.173, P=0.186)。两组共94对匹配成功。匹配后CRT组和CCRT组的中位生存期(95%置信区间)分别为2.14(1.75~2.44)和2.75(2.38~2.92) a,1 a生存率分别为82.24%和85.36%,2 a生存率分别为56.39%和66.20%,3 a生存率分别为23.44%和34.37%,两组生存曲线差异有统计学意义(χ2=11.045,P=0.008)。结论:采用倾向指数匹配法能有效降低非随机化临床试验数据的混杂偏倚。

英文摘要:

Aim: To compare the effects of single chemotherapy ( CRT ) and conformal radiotherapy combined with chemotherapy(CCRT) on limited disease small cell lung cancer (LD-SCLC) patients after balancing the covariates by pro-pensity score .Methods:A total of 224 LD-SCLC patients were subjected ,among which ,109 accepted CRT , and 115 ac-cepted CCRT .A logistic regression model was established ,and the treatment assignment was taken as the dependent varia-ble and the covariates as the independent variables .For each LD-SCLC patient , the propensity score was calculated for cal-iper matching and a survival analysis of the matched data was carried out .Results: Before matching , the median survival time (95%CI) of CRT and CCRT were 2.15(1.96-2.48) and 2.37(2.06-2.72) years,respectively;one-, two-, and three-year survival rates were 82.65%and 83.36%, 59.02% and 64.30%,25.28% and 29.34%, respectively.There was no significant difference in survival curve between the two groups (χ2 =2.173,P=0.186).A total of 94 pairs patients were matched by propensity score .After matching, the median survival time(95%CI) of CRT and CCRT were 2.14(1.75-2.44) and 2.75(2.38-2.92) years;One-, two-, and three-year survival rates were 82.24%and 85.36%, 56.39%and 66.20%, 23.44%and 34.37%, respectively.There was a significant difference in survival curve between the two groups (χ2 =11.045,P=0.008).Conclusion: Propensity score matching can effectively reduce the confounding bias of non-randomized clinical observational data .

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期刊信息
  • 《郑州大学学报:医学版》
  • 中国科技核心期刊
  • 主管单位:河南省教育厅
  • 主办单位:郑州大学
  • 主编:辛世俊
  • 地址:郑州市高新区科学大道100号
  • 邮编:450001
  • 邮箱:xzshi@126.com
  • 电话:0371-67781728
  • 国际标准刊号:ISSN:1671-6825
  • 国内统一刊号:ISSN:41-1340/R
  • 邮发代号:36-111
  • 获奖情况:
  • 综合性医药卫生类核心期刊,教育部优秀科技期刊一等奖,中国优秀科技期刊二等奖
  • 国内外数据库收录:
  • 美国化学文摘(网络版),波兰哥白尼索引,美国剑桥科学文摘,中国中国科技核心期刊,中国北大核心期刊(2008版),中国北大核心期刊(2011版),中国北大核心期刊(2014版)
  • 被引量:15607