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山东大学学报 (医学版) ›› 2021, Vol. 59 ›› Issue (8): 113-118.doi: 10.6040/j.issn.1671-7554.0.2021.0254

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基于逆概率加权法的早期三阴性乳腺癌不同治疗方案的疗效评价

王喆1,刘玉洁1,毛倩1,管佩霞1,包绮晗1,李承圣1,乔晓伟1,潘庆忠2,王素珍1   

  • 出版日期:2021-08-10 发布日期:2021-09-16
  • 通讯作者: 王素珍. E-mail:wangsz@wfmc.edu.cn
  • 基金资助:
    国家自然科学基金(81872719);山东省自然科学基金(ZR2019MH034);全国统计科学研究项目(2018LY79)

Evaluation of the efficacy of different regimens for early triple negative breast cancer based on the inverse probability of treatment weighting method

WANG Zhe1, LIU Yujie1, MAO Qian1, GUAN Peixia1, BAO Qihan1, LI Chengsheng1, QIAO Xiaowei1, PAN Qingzhong2, WANG Suzhen1   

  1. 1. Division of Biostatistics;
    2. Division of Mathematics, School of Public Health, Weifang Medical University, Weifang 261053, Shandong, China
  • Online:2021-08-10 Published:2021-09-16

摘要: 目的 基于逆概率加权法(IPTW)评价保乳术联合术后放疗和乳房切除术治疗早期三阴性乳腺癌患者的疗效。 方法 基于美国SEER数据库,收集2010至2015年诊断为T1-2N0M0期三阴性乳腺癌患者相关资料,通过广义提升模型(GBM)估计倾向指数计算逆概率权重,加权均衡组间协变量后分析两种局部治疗方式对早期三阴性乳腺癌患者生存率的影响。 结果 IPTW后,组间协变量达到完全均衡,log-rank检验结果表明,保乳术联合术后放疗组的总生存率(OS)高于乳房切除术组(P<0.001);多因素Cox回归分析结果显示,保乳术联合术后放疗组与乳房切除术组相比预后更好(HR=0.74,95%CI=0.65~0.84, P<0.001)。 结论 对T1-2N0M0期三阴性乳腺癌患者,保乳术联合术后放疗的疗效优于乳房切除术。

关键词: T1-2N0M0期三阴性乳腺癌, 逆概率加权法, 保乳术联合术后放疗, 乳房切除术, 疗效评价

Abstract: Objective To evaluate the efficacy of breast conserving surgery with postoperative radiotherapy and mastectomy for patients with early triple negative breast cancer based on inverse probability of treatment weighting(IPTW)method. Methods We extracted the data related to patients diagnosed with T1-2N0M0 triple negative breast cancer from the SEER database during 2010 and 2015, calculated the inverse probability weights by estimating the propensity index through the generalized boosted model(GBM), and analyzed the effects of two local treatment modalities on the survival rate of patients with early triple negative breast cancer after weighting the balanced intergroup covariates. Results After IPTW, the covariates between groups reached complete equilibrium, and log-rank test showed that the overall survival(OS)was better in the breast conserving with postoperative radiotherapy group than in the mastectomy group(P<0.001). The multifactorial Cox regression analysis showed that the breast conserving surgery with postoperative radiotherapy remained to be prognostic beneficial compared to mastectomy(HR=0.74, 95%CI=0.65-0.84, P<0.001). Conclusion Breast conserving surgery with postoperative radiotherapy is more effective than mastectomy in patients with T1-2N0M0 triple negative breast cancer.

Key words: T1-2N0M0 triple negative breast cancer, Inverse probability of treatment weighting method, Breast conserving surgery with postoperative radiotherapy, Mastectomy, Efficiency evaluation

中图分类号: 

  • R181
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