Objective: To evaluate the therapeutic effects of surgical resection combined with adjuvant chemotherapy in the patients with limited disease small cell lung cancer(LD-SCLC) based on propensity score matching.Methods: Between 2009 and 2014, 61 surgical resections and 96 non-operatives were performed on patients with disease limited stage small cell lung cancer in our institute.Pretreatment clinical parameters including T stage, N stage, number of lesions and histology were used for propensity score matching.After propensity score matching, 30 operative patients and 30 non-operative patients were selected and compared.Results: The median survival time of operative group was 27 months(95%CI:2.73-51.26), and the other group was 14 months(95%CI:11.8-16.18).After propensity matching, two groups were similar in regards to important variables.The long-term survival time was significant different (27 months vs.17 months, P=0.001).Conclusion: The current propensity score analysis suggests that surgical resection combined with adjuvant chemotherapy can benefit the survival of patients with limited disease small cell lung cancer.%目的: 应用倾向指数匹配法均衡组间协变量,评价手术切除合并辅助化疗对治疗局限期小细胞肺癌的疗效.方法:回顾性分析了本院2009年至2014年间诊断为局限期小细胞肺癌的157例住院患者临床资料,其中61例接受手术切除合并辅助化疗,96例接受单纯化疗或放化疗联合治疗.利用倾向指数评分方法,匹配卡钳值0.20,以治疗方式为因变量,以T分期,N分期,病灶数量和病理分型为协变量,均衡不平衡的协变量,模拟出随机化效果,分别对匹配前后的数据进行生存分析.结果:匹配前,手术组和非手术组的中位生存期分别为27个月(95%CI:2.73~51.26)和14个月(95%CI:11.8~16.18).匹配后,所有协变量分布均达到均衡,比较匹配后两组患者的生存状况,手术组患者的中位生存期为27个月,非手术组中位生存期为17个月(95%CI:13.68~20.32).Log-rank检验两组生存率具有统计学差异,P=0.001.结论:对于局限期小细胞肺癌患者,如果达到手术切除的临床指证,手术切除合并辅助化疗能使患者的生存获益;在治疗前如能准确诊断为小细胞肺癌的患者,临床分期能指导选择合适的治疗策略.
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