术后辅助放疗对B2型胸腺瘤患者预后的影响——多中心、真实世界的回顾性研究  

Effect of postoperative adjuvant radiotherapy on the prognosis of type B2 thymoma patients:A multi-center,retrospective real-world study

作　　者：王旻寒 任秀宇 任振 周云[2] 王强[3] 丁昕 WANG Minhan;REN Xiuyu;REN Zhen;ZHOU Yun;WANG Qiang;DING Xin(Graduate School,Xuzhou Medical University,Xuzhou,Jiangsu 221004,China;Department of Radiation Oncology,Xuzhou Central Hospital,Xuzhou,Jiangsu 221009;Department of Radiation Oncology,Xuzhou Cancer Hospital,Xuzhou,Jiangsu 221006;Department of Radiation Oncology,the Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221002)

机构地区：[1]徐州医科大学研究生院,江苏徐州221004 [2]徐州市中心医院肿瘤放疗科,江苏徐州221009 [3]徐州市肿瘤医院肿瘤放疗科,江苏徐州221006 [4]徐州医科大学附属医院肿瘤放疗科,江苏徐州221002

出　　处：《徐州医科大学学报》2025年第3期215-220,共6页Journal of Xuzhou Medical University

基　　金：江苏省高等学校基础科学(自然科学)研究基金(24KJA320009)。

摘　　要：目的评估术后辅助放疗对完整切除B2型胸腺瘤患者生存获益的影响,为术后是否行辅助放射治疗提供依据。方法选取2008年9月—2024年1月于徐州医科大学附属医院、徐州市中心医院和徐州市肿瘤医院治疗的154例B2型胸腺瘤患者。根据治疗模式将患者分为单纯手术组(72例)及术后放疗组(82例)。收集患者的一般资料、临床特征和放疗相关指标等数据。采用Kaplan-Meier法进行生存分析。应用Cox单因素及多因素回归模型分析影响患者预后的危险因素。结果2组患者在Masaoka-Koga(MK)分期、TNM分期方面比较,差异有统计学意义(P<0.05),而在年龄、性别、体重指数、吸烟史、饮酒史、糖尿病史、高血压病史、肿瘤最大径、包膜完整性、是否合并重症肌无力、手术方式等方面差异无统计学意义(P>0.05)。Kaplan-Meier生存分析结果显示,术后辅助放疗显著提高患者的无病生存期(DFS,P<0.0001)及总生存期(OS,P=0.003)。多因素Cox回归分析结果显示,MK分期(P<0.0001,HR=3.694,95%CI:2.018~6.765)和术后辅助放疗(P<0.0001,HR=0.143,95%CI:0.074~0.277)是影响胸腺瘤患者DFS的独立危险因素。此外,结果显示,MK分期(P<0.0001,HR=6.338,95%CI:2.362~17.006)、术后辅助放疗(P<0.0001,HR=0.096,95%CI:0.034~0.275)和包膜完整(P=0.014,HR=2.930,95%CI:1.244~6.902)是影响患者OS的独立危险因素。结论对于手术完整切除的B2胸腺瘤患者,术后辅助放疗能够提高患者的DFS及OS。Objective To evaluate the impact of postoperative adjuvant radiotherapy on the survival benefits of pa-tients with complete resection of type B2 thymoma,providing evidence for postoperative adjuvant radiotherapy.Methods A total of 154 patients with type B2 thymoma who were treated from September 2008 to January 2024 at the Affiliated Hospital of Xuzhou Medical University,Xuzhou Central Hospital,and Xuzhou Cancer Hospital were selected.Based on treatment modality,the patients were divided into two groups:a surgery group(n=72)and a surgery+radiotherapy group(n=82).Their general data,clinical characteristics,and radiotherapy-related data were collected.Kaplan-Meier survival analysis was conducted.Cox univariate and multivariate regression models were used to analyze the risk factors affecting patient prognosis.Results There were statistical differences between the two groups in terms of Masaoka-Koga(MK)staging and TNM staging(P<0.05),but no significant differences were found in terms of age,gender,body mass index(BMI),smoking history,alcohol consumption history,history of diabetes,hypertension,maximum tumor diame-ter,capsule integrity,presence of myasthenia gravis,or surgical methods(P>0.05).Kaplan-Meier survival analysis showed that postoperative adjuvant radiotherapy significantly improved disease-free survival(DFS,P<0.0001)and over-all survival(OS,P=0.003).Multivariate Cox regression analysis revealed that MK staging(P<0.01,HR=3.694,95%CI:2.018-6.765)and postoperative adjuvant radiotherapy(P<0.01,HR=0.143,95%CI:0.074-0.277)were independent risk factors for DFS in thymoma patients.Additionally,MK staging(P<0.01,HR=6.338,95%CI:2.362-17.006),postoperative adjuvant radiotherapy(P<0.01,HR=0.096,95%CI:0.034-0.275),and capsule in-tegrity(P=0.014,HR=2.930,95%CI:1.244–6.902)were identified as independent risk factors for OS.Conclu-sions Postoperative adjuvant radiotherapy can significantly improve the DFS and OS of patients with completely resected Type B2 thymoma.

关 键 词：术后放疗 胸腺瘤 B2型胸腺瘤 Masaoka-Koga分期 

分 类 号：R734.5[医药卫生—肿瘤]