scholarly journals Treatment outcomes of re-irradiation using stereotactic ablative radiotherapy to lung: a propensity score matching analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Tae Hoon Lee ◽  
Dong-Yun Kim ◽  
Hong-Gyun Wu ◽  
Joo Ho Lee ◽  
Hak Jae Kim
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Local Control ◽  
Lung Tumor ◽  
Survival Rates ◽  
Local Control Rate ◽  
Stereotactic Ablative Radiotherapy ◽  
Matched Cohort ◽  
Metastatic Lung Tumor ◽  
Propensity Score Matching Analysis

Abstract Background The purpose of this study was to compare the treatment efficacy and safety of re-irradiation (re-RT) using stereotactic ablative radiotherapy (SABR) and initial SABR for primary, recurrent lung cancer or metastatic lung tumor. Methods A retrospective review of the medical records of 336 patients who underwent lung SABR was performed. Re-RT was defined as the overlap of the 70% isodose line of second-course SABR with that of the initial radiotherapy, and 20 patients were classified as the re-RT group. The median dose of re-RT using SABR was 54 Gy (range 48–60 Gy), and the median fraction number was 4 (range 4–6). One-to-three case-matched analysis with propensity score matching was used, and 60 patients were included in the initial SABR group of the matched cohort. Results The 1- and 2-year local control rates for the re-RT group were 73.9% and 63.3% and those for the initial SABR group in the matched cohort were 92.9% and 87.7%, respectively (P = 0.013). There was no difference in distant metastasis-free, progression-free, and overall survival rates. The crude grade ≥ 2 toxicity rates were 40.0% for the re-RT group and 25.0% for the initial SABR group (P = 0.318). Re-RT group had higher acute grade ≥ 2 toxicity rates (25.0% vs 5.0%, P = 0.031). One incident of grade 3 toxicity (pulmonary) was reported in the re-RT group; there was no grade 4‒5 toxicity. Conclusions The local control rate of the in-field re-RT SABR was lower than that of the initial SABR without compromising the survival rates. The toxicity of re-RT using SABR was acceptable.

scholarly journals Comparison of Minimally Invasive versus Open Pancreatoduodenectomy for Pancreatic Ductal Adenocarcinoma: A Propensity Score Matching Analysis

Cancers ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 982 ◽  
Author(s):  
Jaewoo Kwon ◽  
Ki Byung Song ◽  
Seo Young Park ◽  
Dakyum Shin ◽  
Sarang Hong ◽  
...  
Keyword(s):  
Propensity Score ◽  
Minimally Invasive ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Propensity Score Matching ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Ductal Adenocarcinoma ◽  
Propensity Score Matching Analysis ◽  
Oncological Outcomes ◽  
Hospital Stays

Background: Few studies have compared perioperative and oncological outcomes between minimally invasive pancreatoduodenectomy (MIPD) and open pancreatoduodenectomy (OPD) for pancreatic ductal adenocarcinoma (PDAC). Methods: A retrospective review of patients undergoing MIPD and OPD for PDAC from January 2011 to December 2017 was performed. Perioperative, oncological, and survival outcomes were analyzed before and after propensity score matching (PSM). Results: Data from 1048 patients were evaluated (76 MIPD, 972 OPD). After PSM, 73 patients undergoing MIPD were matched with 219 patients undergoing OPD. Operation times were longer for MIPD than OPD (392 vs. 327 min, p < 0.001). Postoperative hospital stays were shorter for MIPD patients than OPD patients (12.4 vs. 14.2 days, p = 0.040). The rate of overall complications and postoperative pancreatic fistula did not differ between the two groups. Adjuvant treatment rates were higher following MIPD (80.8% vs. 59.8%, p = 0.002). With the exception of perineural invasion, no differences were seen between the two groups in pathological outcomes. The median overall survival and disease-free survival rates did not differ between the groups. Conclusions: MIPD showed shorter postoperative hospital stays and comparable perioperative and oncological outcomes to OPD for selected PDAC patients. Future randomized studies will be required to validate these findings.

scholarly journals Treatment of intracranial meningioma with single-session and fractionated radiosurgery: a propensity score matching study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Sheng-Han Huang ◽  
Chun-Chieh Wang ◽  
Kuo-Chen Wei ◽  
Cheng-Nen Chang ◽  
Chi-Cheng Chuang ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Local Control ◽  
Local Control Rate ◽  
Intracranial Meningioma ◽  
Single Session ◽  
Benign Meningioma ◽  
Efficient Treatment ◽  
The Difference

Abstract Single-session stereotactic radiosurgery (SSRS) is recognized as a safe and efficient treatment for meningioma. We aim to compare the long-term efficacy and safety of fractionated stereotactic radiotherapy (FSRT) with SSRS in the treatment of grade I meningioma. A total of 228 patients with 245 tumors treated with radiosurgery between March 2006 and June 2017were retrospectively evaluated. Of these, 147 (64.5%) patients were treated with SSRS. The remaining 81 patients (35.5%) were treated with a fractionated technique. Protocols to treat meningioma were classified as 12–16 Gy per fraction for SSRS and 7 Gy/fraction/day for three consecutive days to reach a total dose of 21 Gy for FSRT. In univariate and multivariate analyses, tumor volume was found to be associated with local control rate (hazard ratio = 4.98, p = 0.025). The difference in actuarial local control rate (LCR) between the SSRS and FSRT groups after propensity score matching (PSM) was not statistically significant during the 2-year (96.86% versus 100.00%, respectively; p = 0.175), 5-year (94.76% versus 97.56%, respectively; p = 0.373), and 10-year (74.40% versus 91.46%, respectively; p = 0.204) follow-up period. FSRT and SSRS were equally well-tolerated and effective for the treatment of intracranial benign meningioma during the10-year follow-up period.

Propensity score matching analysis of patients with inoperable stage III NSCLC treated with chemoradio- vs. chemoradioimmunotherapy.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e21087-e21087
Author(s):  
Farkhad Manapov ◽  
Julian Taugner ◽  
Lukas Käsmann ◽  
Chukwuka Eze ◽  
Olarn Roengvoraphoj ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Survival Rates ◽  
Progression Free Survival ◽  
Stage Iii ◽  
Regional Recurrence ◽  
Recurrence Rates ◽  
Propensity Score Matching Analysis ◽  
Platinum Based Chemotherapy ◽  
Stage Iii Nsclc

e21087 Background: Chemoradiotherapy (CRT) followed by consolidation treatment with the PD-L1 Inhibitor durvalumab is the new standard of care for inoperable stage III NSCLC. The present study compares outcome of patients treated with CRT alone to those treated with additional concurrent and/or sequential immune check-point inhibition (CRT-IO) using propensity-score matching analysis (PSM). Methods: PSM was performed with retro- and prospectively collected data of patients treated with CRT or CRT-IO (consolidation with durvalumab/concurrent and consolidation with nivolumab). Overall survival (OS), progression free survival (PFS) and time to loco-regional recurrence (defined as progression in the mediastinum and ipsilateral lung) were calculated from last day of thoracic irradiation. Results: Sixty-two (37%) of 166 treated patients were successfully matched; 31 received CRT and 31 CRT-IO. 18F-FDG-PET/CT for treatment planning was performed in 97% and cranial contrast enhanced MRI in 81% of patients. PSM was based on age, gender, PTV volume, histology, T- and N-stage. 36 and 51% vs. 42 and 46% of patients had T4- and N3-disease in the CRT and CRT-IO cohorts, respectively. All patients were irradiated to a total dose of at least 60Gy (EQD2). 90% of patients received two cycles of concomitant platinum-based chemotherapy (CRT: 82%, CRT-IO 96%). The median follow-up for 62 patients was 17.3 (range: 1.7-96.0) months. Median PFS was 7.1 (95%CI 2.2-12.1) months in CRT vs. 13.8 (95%CI 13.1-14.5) in CRT-IO patients (p = 0.004). Twelve-month PFS rates were 30% and 55% in the CRT and the CRT-ICI cohort, respectively. Median time to loco-regional recurrence was 15.3 months for CRT vs. not reached for CRT-IO patients (p = 0.050). 12-month loco-regional recurrence rates were 43% vs. 22%; 6- and 12-month brain metastases rates after completion of radiotherapy in the CRT vs. CRT-ICI cohort were 8% and 26% vs. 0% and 20%, respectively. Median OS was 19.1 (8.4-29.8 95%CI) months for CRT and not reached for CRT-IO patients (p < 0.001). 12-month survival rates were 62% and 93% in the CRT and CRT-IO cohort, respectively. Conclusions: The addition of concurrent and/or sequential IO to CRT led to an impressive improvement of loco-regional control, PFS and OS in the matching cohorts.

scholarly journals Propensity score-matching analysis comparing laparoscopic and open pancreaticoduodenectomy in elderly patients

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Heeji Shin ◽  
Ki Byung Song ◽  
Young Il Kim ◽  
Young-Joo Lee ◽  
Dae Wook Hwang ◽  
...  
Keyword(s):  
Propensity Score ◽  
Elderly Patients ◽  
Propensity Score Matching ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Propensity Score Matching Analysis ◽  
Oncological Outcomes ◽  
Pancreatic Fistulas ◽  
Clinically Significant ◽  
Open Pancreaticoduodenectomy

Abstract There is little evidence on the safety and benefits of laparoscopic pancreaticoduodenectomy (LPD) in elderly patients; therefore, we evaluated the feasibility and efficacy of this procedure by comparing perioperative and oncological outcomes between LPD and open pancreaticoduodenectomy (OPD) in elderly patients. We retrospectively reviewed the data of 1,693 patients who underwent PD to manage periampullary tumours at a single institution between January 2014 and June 2017. Of these patients, 326 were elderly patients aged ≥70 years, with 56 patients allocated to the LPD group and 270 to the OPD group. One-to-one propensity score matching (56:56) was used to match the baseline characteristics of patients who underwent LPD and OPD. LPD was associated with significantly fewer clinically significant postoperative pancreatic fistulas (7.1% vs. 21.4%), fewer analgesic injections (10 vs. 15.6 times; p = 0.022), and longer operative time (321.8 vs. 268.5 minutes; p = 0.001) than OPD in elderly patients. There were no significant differences in 3-year overall and disease-free survival rates between the LPD and OPD groups. LPD had acceptable perioperative and oncological outcomes compared with OPD in elderly patients. LPD is a reliable treatment option for elderly patients with periampullary tumours.

scholarly journals Association between intraoperative administration of dexamethasone and survival after curative resection for non-small cell lung cancer (NSCLC): A propensity score matching analysis

2020 ◽  
Author(s):  
Fang Yan ◽  
Gang Chen ◽  
Jingdun Xie ◽  
Huaqiang Zhou ◽  
Wei Xing ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Cox Regression ◽  
Small Cell ◽  
Matched Cohort ◽  
Small Cell Lung ◽  
Inhaled Anesthetics ◽  
Propensity Score Matching Analysis ◽  
Nsclc Patients

Abstract Background: Few studies have suggested the correlation between intraoperative dexamethasone and oncological outcomes in non-small cell lung cancer (NSCLC) patients with radical resection. The existing data are inconsistent and inadequate, and more evidence is needed. We therefore undertook a propensity-matched cohort study to investigate the correlation.Methods: 832 patients with stage I to IIIa NSCLC who went through lung tumor resection between January 2008 and December 2013 were enrolled in our study. Propensity-score matching analysis created a population of 260 patients in the non-DEX group and 130 patients in the DEX group. Cox regression analyses were applied to compare the disease-free survival (DFS) and overall survival (OS) between patients who did not and did receive dexamethasone in the propensity score-matched cohort, as well as in the certain patients with high-risk factors of postoperative nausea and vomiting (PONV).Results: After propensity score matching, intraoperative dexamethasone was not significantly associated with DFS (HR: 0.944, 95%CI: 0.720-1.237, P = 0.655) and OS (HR: 1.210, 95%CI: 0.927-1.581, P = 0.486). Multivariable cox regression analysis revealed that intraoperative dexamethasone was not independent prognostic factor for DFS and OS in NSCLC patients undergoing surgical resection. In the subgroup analysis, including female subgroup, nonsmoking subgroup, long anesthetic time subgroup, VATS subgroup and inhaled anesthetics subgroup, intraoperative dexamethasone was not significantly associated with DFS and OS.Conclusion: There was no correlation between intraoperative administration of dexamethasone and survival in NSCLC patients after curative surgery. In the high-risk subgroups of PONV, that is, female, nonsmoking, long anesthetic time, VATS and inhaled anesthetics, patients given intraoperative dexamethasone had no better or poorer prognosis compared with patients not given intraoperative dexamethasone.

Subacute/chronic type A aortic dissection: a retrospective cohort study

2019 ◽  
Author(s):  
Jinlin Wu ◽  
Enzehua Xie ◽  
Juntao Qiu ◽  
Yan Huang ◽  
Wenxiang Jiang ◽  
...  
Keyword(s):  
Propensity Score ◽  
Aortic Dissection ◽  
Propensity Score Matching ◽  
Survival Rates ◽  
Type A ◽  
Chronic Type ◽  
Type A Aortic Dissection ◽  
Propensity Score Matching Analysis ◽  
Clinical Presentations ◽  
Late Survival

Abstract OBJECTIVES Our goal was to outline the clinical presentations, surgical treatment and outcomes of subacute/chronic type A aortic dissection (TAAD). METHODS A total of 1092 patients with TAAD were enrolled retrospectively and divided into 2 groups based on acuity of TAAD (181 subacute/chronic vs 911 acute cases of TAAD). Early and late outcomes were investigated and compared using propensity score matching. RESULTS The top 3 symptoms for subacute/chronic TAAD were chest tightness (80/181, 44.2%), mild pain (65/181, 35.9%) and sweating (58/181, 32.0). Fifteen (15/181, 8.3%) patients were symptom-free. Typical symptoms of acute TAAD were less common in patients with subacute/chronic TAAD such as intense/sharp pain (48/181, 26.5%), tear-like pain (35/181, 19.3%) and radiating pain (30/181, 16.6%). Patients with subacute/chronic TAAD had better early and late survival rates, with an early mortality rate of 6.1% (11/181) compared to 11.6% (106/911) of those with acute TAAD (P = 0.038). Before propensity score matching, survival at 1, 3 and 5 years was 93.1% [95% confidence interval (CI) 89.4–96.9%], 88.4% (95% CI 83.1–93.9%) and 86.4% (95% CI 80.1–93.1%) for subacute/chronic TAAD and 86.9% (95% CI 84.7–89.2%), 82.6% (95% CI 79.9–85.3%) and 79.0% (95% CI 75.5–82.7%) for acute TAAD, respectively (P = 0.039). The propensity score matching analysis substantiated the foregoing results. CONCLUSIONS Subacute/chronic TAAD was clearly distinct from acute TAAD in terms of clinical presentations and had better early and late survival rates. Current surgical strategies for acute TAAD are applicable to subacute/chronic TAAD with excellent outcomes.

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