Table 1_Establishment and validation of a survival prediction model for stage IV non-small cell lung cancer: a real-world study.xlsx

ObjectiveThe aim of this study is to develop and validate a predictive model for predicting survival in individual advanced non-small cell lung cancer patients by integrating basic patient information and clinical data.
MethodsA total of 462 patients with advanced non-small cell lung cancer collected from Shanxi Cancer Hospital were randomly assigned (in a 7:3 ratio) to a training cohort and an internal validation cohort. Independent factors affecting patients’ 3-year survival were screened and predictive models were created by using a single-factor followed by multifactor Cox regression analysis. Evaluate the performance of the model using the consistency index (C-index), calibration curves, receiver operating characteristic curves (ROC) and decision curve analysis (DCA). The collected patients who received chemotherapy alone and those who received chemotherapy combined with immunotherapy were statistically paired using propensity score matching between the two groups, and subgroup analyses were performed among the screened variables.
ResultsA better prognostic model was created and a nomogram chart visualizing the model was drawn. Based on the median risk score of the training cohort, all individuals were categorized into high- and low-risk groups, with the high-risk group having worse OS in both cohorts (P<0.05). The results of subgroup analysis showed that chemotherapy alone versus chemotherapy combined with immunotherapy in patients with advanced NSCLC affected OS.
ConclusionA clinical predictive model was developed to predict 3-year survival in patients with advanced non-small cell lung cancer. The study demonstrated that chemotherapy combined with immunotherapy is superior to chemotherapy alone.

研究目的 本研究旨在整合患者基础信息与临床数据，开发并验证一款可用于预测晚期非小细胞肺癌（advanced non-small cell lung cancer, NSCLC）患者个体生存情况的预测模型。研究方法 本研究纳入山西省肿瘤医院收治的462例晚期非小细胞肺癌患者，以7:3的比例随机划分为训练队列与内部验证队列。通过单因素及多因素Cox回归分析，筛选影响患者3年生存的独立危险因素并构建预测模型。采用一致性指数（C-index）、校准曲线、受试者工作特征曲线（receiver operating characteristic curves, ROC）以及决策曲线分析（decision curve analysis, DCA）对模型性能进行评估。针对仅接受化疗与接受化疗联合免疫治疗的入组患者，采用倾向得分匹配法（propensity score matching）进行组间配对统计，并基于筛选出的变量开展亚组分析。研究结果 本研究成功构建了一款性能更优的预后模型，并绘制了可视化该模型的列线图（nomogram）。基于训练队列的中位风险评分，将所有患者划分为高风险组与低风险组；两组患者的总生存期（overall survival, OS）均存在显著差异，高风险组预后更差（P<0.05）。亚组分析结果显示，晚期非小细胞肺癌患者中，化疗联合免疫治疗方案与单纯化疗方案对总生存期的影响存在差异。研究结论 本研究开发了一款可用于预测晚期非小细胞肺癌患者3年生存情况的临床预测模型。研究证实，化疗联合免疫治疗方案的疗效优于单纯化疗方案。