[1]赵晓蒙),李炳海),王素珍)#,等.基于倾向指数匹配法的局限期小细胞肺癌的生存分析*[J].郑州大学学报(医学版),2014,(01):62.
 ZHAO Xiaomeng#,LI Binghai#,WANG Suzhen#,et al.Survival analysis for limited disease small cell lung cancer based on propensity score matching method[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2014,(01):62.
点击复制

基于倾向指数匹配法的局限期小细胞肺癌的生存分析*
分享到:

《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2014年01期
页码:
62
栏目:
应用研究
出版日期:
2014-01-20

文章信息/Info

Title:
Survival analysis for limited disease small cell lung cancer based on propensity score matching method
作者:
赵晓蒙1)李炳海2)王素珍1)#任艳峰1)王小礼3)
1)潍坊医学院公共卫生学院卫生统计学教研室 潍坊 2610532)潍坊医学院财务处 潍坊 2610533)山东省肿瘤医院放疗科 济南 250117
Author(s):
ZHAO Xiaomeng1)#LI Binghai2)#WANG Suzhen1)#REN Yanfeng1)#WANG Xiaoli3)#
1)Department of Health Statistics, Faculty of Preventative Medicine, Weifang Medical College, Weifang 2610532)Financial Department, Weifang Medical College, Weifang 2610533)Department of Radiotherapy, Tumor Hospital of Shandong Province, Jinan 250117
关键词:
倾向指数匹配法局限期小细胞肺癌生存分析
Keywords:
propensity score matching method limited disease small cell lung cancer survival analysis
分类号:
R734.2
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。
Abstract:
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 propensity score. Methods: A total of 224 LDSCLC patients were subjected,among which,109 accepted CRT, and 115 accepted CCRT. A logistic regression model was established,and the treatment assignment was taken as the dependent variable and the covariates as the independent variables. For each LDSCLC patient, the propensity score was calculated for caliper 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.

参考文献/References:

[1]Pignon JP,Arriagada R,Ihde DC,et al.A metaanalysis of thoracic radiotherapy for smallcell lung cancer[J].N Engl J Med,1992,327(23):1618 [2]Warde P,Payne D.Does thoracic irradiation improve survival and local control in limitedstage smallcell carcinoma of the lung:a metaanalysis[J].J Clin Oncol,1992,10(6):890 [3]Rosenbaum PR,Rubin DB.The central role of the propensity score in observational studies for causal effects[J].Biometrika,1983,70(1):41 [4]Hong S,Youn YN,Yi G,et al.Long term results of STsegment elevation myocardial infarction versus nonSTsegment elevation myocardial infarction after offpump coronary artery bypass grafting: propensity score matching analysis[J].J Korean Med Sci,2012,27(2):153 [5]Berger JS,Herout PM,Harshaw Q,et al.Bleedingassociated outcomes with preoperative clopidogrel use in on and offpump coronary artery bypass[J].J Thromb Thrombolysis,2012,34(1):56 [6]Choi AH,BarnholtzSloan JS,Kim JA.Effect of radiation therapy on survival in surgically resected retroperitoneal sarcoma: a propensity scoreadjusted SEER analysis[J].Ann Oncol,2012,23(9):2449 [7]Linden A,Adams JL.Combining the regression discontinuity design and propensity scorebased weighting to improve causal inference in program evaluation[J].J Eval Clin Pract,2012,18(2):317 [8]Austin PC,Mamdani MM.A comparison of propensity score methods: a casestudy estimating the effectiveness of postAMI statin use[J].Stat Med,2006,25(12):2084 [9]王永吉,蔡宏伟,夏结来,等.倾向指数第二讲:倾向指数常用研究方法[J].中华流行病学杂志,2010,31(5):584 [10]Carpenter A.Carpenter's complete guide to the SAS macro language[M].2nd ed.SAS Institute,2004. [11]Brookhart MA,Schneeweiss S,Rothman KJ,et al.Variable selection forpropensity score models[J].Am J Epidemiol,2006,163(12):1149 [12]Hullsiek KH,Louis TA.Propensity score modeling strategies for the causal analysis of observational data[J].Biostatistics,2002,3(2):179 [13]Scrutinio D,Passantino A,Catanzaro R,et al.Inpatient cardiac rehabilitation soon after hospitalization for acute decompensated heart failure: a propensity score study[J].J Cardiopulm Rehabil Prev,2012,32(2):71 [14]Foody JM,Cole CR,Blackstone EH,et al.A propensity analysis of cigarette smoking and mortality with consideration of the effects of alcohol[J].Am J Cardiol,2001,87(6):706 [15]Yaginuma K,Kasai T,Miyauchi K,et al.Propensity score analysis of 10year longterm outcome after bypass surgery or plain old balloon angioplasty in patients with metabolic syndrome[J].Int Heart J,2011,52(6):372 [16]王永吉,蔡宏伟,夏结来,等.倾向指数匹配法与Logistic回归分析方法对比研究[J].现代预防医学,2011,38(12):2217 [17]王永吉,蔡宏伟,夏结来,等.倾向指数第一讲:倾向指数的基本概念和研究步骤[J].中华流行病学杂志,2010,31(3):347

相似文献/References:

[1]王素珍△,孟维静,赵晓蒙,等.经倾向指数匹配后的肝癌患者疗效评价*[J].郑州大学学报(医学版),2012,(06):769.
 WANG Suzhen,MENG Weijing,ZHAO Xiaomeng,et al.Effect evaluation of hepatocellular carcinoma patients after propensity score matching[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2012,(01):769.

备注/Memo

备注/Memo:
*国家自然科学基金项目81141112,81101290;山东省自然科学基金项目ZR2009CM117;#通讯作者,女,1967年1月生,博士,教授,研究方向:临床试验设计方法及信息处理,Email: wangsz@wfmc.edu.cn
更新日期/Last Update: 2014-02-20