Radiotherapy for patients with stage IV classical Hodgkin lymphoma: a propensity-matched analysis of the surveillance, epidemiology, and end results database.,Cancer Biology & Therapy

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Radiotherapy for patients with stage IV classical Hodgkin lymphoma: a propensity-matched analysis of the surveillance, epidemiology, and end results database.
Cancer Biology & Therapy ( IF 4.4 ) Pub Date : 2020-08-23 , DOI: 10.1080/15384047.2020.1796194
Shijie Wang ₁ , Mingfang Jia ₂ , Jianglong Han ₁ , Rui Zhang ₁ , Kejie Huang ₁ , Ping Li ₁ , Qin Li ₁ , Yunfeng Qiao ₁ , Qibin Song ₁ , Zhenming Fu ₁

Affiliation

Background

The survival advantage of radiotherapy for patients with stage IV classic Hodgkin lymphoma (HL) has not been adequately evaluated.

Methods

We analyzed patients with stage IV HL enrolled from the Surveillance, Epidemiology, and End Results (SEER) registry from January 2000 to December 2012. Propensity score (PS) analysis with 1:2 matching was performed to ensure well-balanced characteristics of the comparison groups. Kaplan-Meier and Cox proportional hazardous model were used to evaluate the overall survival (OS), cancer-specific survival (CSS), the hazards ratio (HR) and corresponding 95% confidence intervals (95% CI).

Results

Overall, for all patients with stage IV HL, receiving radiotherapy was associated with both significantly improved OS and CSS. Radiotherapy to any lesions could independently improve the OS and CSS by 30% to 36% in the multivariate analyses before and after PS matching (PSM), with the best improvement of 33% to 40% observed for patients with nodular sclerosis (P < 0.05) among all HL pathological types. In particular, radiotherapy, most likely to the residual site, was more pronouncedly associated with the improvement in survival for patients with stage IV HL who were young (age<45, P < .05) or without B symptoms (P_Interaction for OS = 0.099, P_Interaction for CSS = 0.255). For those patients without B symptoms, after PSM, the OS was improved by 65% (P = .021).

Conclusions

The large SEER results support that radiotherapy is associated with better survival of patients with stage IV HL.

中文翻译：

IV 期经典霍奇金淋巴瘤患者的放射治疗：对监测、流行病学和最终结果数据库的倾向匹配分析。

背景

放疗对 IV 期经典霍奇金淋巴瘤 (HL) 患者的生存优势尚未得到充分评估。

方法

我们分析了 2000 年 1 月至 2012 年 12 月从监测、流行病学和最终结果 (SEER) 注册登记的 IV 期 HL 患者。进行了 1:2 匹配的倾向评分 (PS) 分析以确保比较的均衡特征组。Kaplan-Meier 和 Cox 比例风险模型用于评估总生存率 (OS)、癌症特异性生存率 (CSS)、风险比 (HR) 和相应的 95% 置信区间 (95% CI)。

结果

总体而言，对于所有 IV 期 HL 患者，接受放疗与 OS 和 CSS 均显着改善相关。在PS匹配（PSM）前后的多变量分析中，对任何病灶进行放疗均可独立改善OS和CSS 30%～36%，其中结节性硬化症患者的改善最佳为33%～40%（P < 0.05 ) 在所有 HL 病理类型中。特别是，对于年轻（年龄<45，P < .05）或没有 B 症状（ OS 的P_交互作用= 0.099, P_相互作用 对于 CSS = 0.255）。对于那些没有 B 症状的患者，PSM 后，OS 提高了 65% ( P = .021)。