Đánh giá mô hình điều trị thực tế và kết quả lâm sàng ở bệnh nhân ung thư phổi không phải tế bào nhỏ giai đoạn iii: góc nhìn từ nghiên cứu kindle

Đánh giá mô hình điều trị thực tế và kết quả lâm sàng ở bệnh nhân ung thư phổi không phải tế bào nhỏ giai đoạn iii: góc nhìn từ nghiên cứu kindle - việt nam

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Bảo Tuấn Diệp, Thùy Trang Nguyễn, Tuấn Khôi Nguyễn, Thị Ngọc Trâm Võ

Ngôn ngữ: vie

Ký hiệu phân loại: 616.994 +Cancers

Thông tin xuất bản: Tạp chí y học việt nam (tổng hội y học việt nam), 2022

Mô tả vật lý: 163-174

Bộ sưu tập: Metadata

ID: 489428

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Dữ liệu hồi cứu từ những bệnh nhân được chẩn đoán ung thư phổi không tế bào nhỏ (NSCLC) giai đoạn III (AJCC, ấn bản lần thứ 7) từ tháng 1 năm 2013 đến tháng 12 năm 2017 với ít nhất 9 tháng theo dõi được thu thập từ 2 trung tâm ở Việt Nam (BV Ung Bướu TP. HCM và BV K).( )Thống kê mô tả được sử dụng để tóm tắt nhân khẩu học, đặc điểm bệnh tật và phương thức điều trị. Phương pháp Kaplan-Meier đánh giá ước tính sống sót
Khoảng tin cậy 95% (KTC) 2 mặt được tính toán. Thống kê suy luận được sử dụng để đánh giá tương quan giữa các biến số lâm sàng và điều trị với trung vị thời gian sống còn không bệnh tiến triển (mPFS) và trung vị thời gian sống còn toàn bộ (mOS). Kết quả(:) Tổng số 150 bệnh nhân (tuổi trung bình(:) 60 tuổi [thay đổi từ 26 - 82]) đã được tuyển tham gia nghiên cứu
75,3% là nam, 62,0% có tiền sử hút thuốc, 56,4% mắc bệnh giai đoạn IIIB và 62,5% bị ung thư biểu mô tuyến. Phần lớn các trường hợp (97,3%) không được hội chẩn đa chuyên khoa. Nhìn chung, hóa trị đơn thuần (43,3%), xạ trị đơn thuần (17,0%), hóa xạ trị tuần tự (13,5%) và hóa xạ trị đồng thời (12,8%) được ưu tiên dùng làm liệu pháp ban đầu. Điều trị dựa trên phẫu thuật được thực hiện ở một số ít bệnh nhân (giai đoạn IIIA(:) 10%
giai đoạn IIIB(:) 1,3%). Liệu pháp giảm nhẹ là phương pháp điều trị được sử dụng phổ biến nhất khi tái phát lần thứ hai và thứ ba. mPFS và mOS cho nhóm thuần tập Việt Nam lần lượt là 8,7 tháng (95% CI, 7,59-9,72) và 25,7 tháng (95% CI, 19,98 - 42,61). mPFS và mOS cho giai đoạn IIIA là 11,9 tháng (95% CI, 8,64 - 14,95) và 28,2 tháng (95% CI, 24,15 - không tính được) và cho giai đoạn IIIB là 7,8 tháng (95% CI, 6,64 - 8,71) và 20,0 tháng (KTạp chí 95%, 13,01 - 42,61).( )Kết luận(:) Nghiên cứu KINDLE - Việt Nam cung cấp thông tin chi tiết về các phát hiện lâm sàng của NSCLC giai đoạn III. Các chiến lược để cải thiện kết quả lâm sàng ở nhóm bệnh nhân này bao gồm giáo dục bác sĩ, tổ chức hội chẩn đa chuyên khoa và tăng khả năng tiếp cận với các phương pháp điều trị mới như liệu pháp miễn dịch và liệu pháp nhắm đích.Retrospective data from patients diagnosed with stage III NSCLC (American Joint Committee on Cancer, 7th edition) between January 2013 and December 2017 with at least 9 months of follow-up were collected from 2 centres in Vietnam. Descriptive statistics were used to summarise demographics, disease characteristics and treatment modalities. Kaplan-Meier methodology evaluated survival estimates
2-sided 95% confidence intervals (CIs) were computed. Inferential statistics were used to correlate clinical and treatment variables with median progression-free survival (mPFS) and median overall survival (mOS). Results(:) A total of 150 patients (median age(:) 60 years [range 26 - 82]) were enrolled
75.3% were male, 62.0% had smoking history, 56.4% had stage IIIB disease and 62.5% had( )adenocarcinoma. The majority of the cases (97.3%) were not discussed at a multidisciplinary team meeting. Overall, chemotherapy alone (43.3%), radiotherapy alone (17.0%), sequential chemoradiation (13.5%) and concurrent chemoradiation (12.8%) were preferred as initial therapy. Surgery-based treatment was administered in limited patients (stage IIIA, 10%
stage IIIB, 1.3%). Palliative therapy was the most commonly administered treatment upon relapse in the second - and third - line setting. The mPFS and mOS for the Vietnam cohort were 8.7 months (95% CI, 7.59 - 9.72) and 25.7 months (95% CI, 19.98 - 42.61), respectively. The mPFS and mOS for stage IIIA were 11.9 months (95% CI, 8.64 - 14.95) and 28.2 months (95% CI, 24.15 - not-calculable) and for stage IIIB were 7.8 months (95% CI, 6.64 - 8.71) and 20.0 months (95% CI, 13.01 - 42.61). Conclusions(:) KINDLE-Vietnam offers insights into the clinical findings of stage III NSCLC. There is a high unmet need for identifying patients in the early stages of NSCLC. Strategies for improving clinical outcomes in this patient population include physician education, multidisciplinary management and catering to increased access to novel agents like immunotherapy and targeted therapy.

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