Tumor related atelectasis(TRA) is an essential factor affecting survival that can cause chest pain, cough, hemoptysis, chest tightness, dyspnea, and even death. In the current study, we explored the possible impact of TRA on survival in cancer patients and the guiding significance of 18F-positron emission tomography/computed(PET/CT) in radiotherapy for patients with atelectasis tumors.

In this retrospective study, we analyzed the treatment model and survival of patients with centrally located non-small cell lung cancer(NSCLC) treated with radiotherapy at two medical centers between May 2005 and August 2019. We identified 152 eligible patients and used propensity score matching (1:1) to process the data to reduce confounding factors, data bias, and mal-distribution.

We used propensity scores created well-matched groups of 57 patients overall with or without TRA. The one-year survival rate of all patients was 71.9%, and the two-year survival rate was 33.3%. Compared to the atelectasis group, the overall survival (OS) of patients in the non-atelectasis group was significantly prolonged (25 months vs. 17 months, p = 0.004), as well as in the atelectasis recovery group (28 months vs. 14 months, p = 0.008). In multivariate analysis, non-atelectasis was closely correlated with favorable OS (HR, 1.804 (−2.840); 95% CI, 1.145–2.840; p = 0.011).

PET/CT can accurately stage NSCLC and better guide the treatment of NSCLC complicated with atelectasis. Tumor-associated atelectasis in patients with centrally located NSCLC can lead to is a poor prognostic marker.

肿瘤相关性肺不张（TRA）是影响生存的重要因素，可导致胸痛、咳嗽、咯血、胸闷、呼吸困难，甚至死亡。在本研究中，我们探讨了 TRA 对癌症患者生存的可能影响以及 18F 正电子发射断层扫描/计算机 (PET/CT) 在肺不张肿瘤患者放射治疗中的指导意义。

在这项回顾性研究中，我们分析了 2005 年 5 月至 2019 年 8 月期间在两个医疗中心接受放射治疗的中心性非小细胞肺癌 (NSCLC) 患者的治疗模式和生存情况。我们确定了 152 名符合条件的患者并使用倾向评分匹配(1:1) 处理数据以减少混杂因素、数据偏差和分布不均。

我们使用倾向评分创建了由 57 名有或没有 TRA 的患者组成的良好匹配组。所有患者一年生存率为71.9%，两年生存率为33.3%。与肺不张组相比，非肺不张组患者的总生存期 (OS) 显着延长（25 个月 vs. 17 个月，p = 0.004），肺不张恢复组（28 个月 vs. 14个月，p = 0.008）。在多变量分析中，非肺不张与良好的 OS 密切相关（HR，1.804 (-2.840)；95% CI，1.145–2.840；p = 0.011）。

PET/CT可以准确分期NSCLC，更好地指导NSCLC合并肺不张的治疗。位于中心的 NSCLC 患者的肿瘤相关肺不张可导致预后不良。