Robust Treatment Comparison Based on Utilities of Semi-Competing Risks in Non-Small-Cell Lung Cancer
基于半竞争风险效用的非小细胞肺癌稳健治疗比较AI 解读 ↓
← 返回论文列表与筛选
阅读说明
本页整理公开书目信息，不生成学术质量评分。AI 解读根据题名及所注明的摘要或原文片段生成，未完成全文核验，可能有误；具体假设、证明与结论请核对原文。摘要保留来源文本，未经模型改写。
DOI 首次登记不等于接收或发表日期。部分更正、评论等条目没有独立摘要；缺少可靠材料时保留待补状态。
引用量采用 OpenAlex 单条关联记录，不合计多个记录；关联记录可能包含正式发表版本，不等于此版本单独引用。缺失不视为零，引用指标不代表论文质量。
关注作者按书目中的完整姓名匹配，同名和姓名变体需人工辨别。相关论文先按共享细分方向和具体方法排列，再参考通用方法与发表日期。
分类依据与纠错
AI 根据所提供的论文材料归类：摘要明确设计随机临床试验比较两种治疗，并讨论后续治疗对所研究治疗效应的混杂。
反馈分类问题
正在核对关联版本…
代码、数据与补充材料
正在核对对应版本的资源…
基于半竞争风险效用的非小细胞肺癌稳健治疗比较
- 研究问题
- 论文研究复发非小细胞肺癌的二线治疗比较：在化疗中加入再次放疗的潜在疗效收益，是否足以抵偿毒性风险增加。
- 方法与思路
- 作者设计随机试验，以进展或死亡与严重毒性构成半竞争风险，用分段指数贝叶斯模型及医生赋予的效用进行后验比较。
- 材料陈述的贡献
- 摘要提出基于后验平均效用的比较检验，并报告模拟评价、效用敏感性分析、类似试验的设计指南及模拟与实施程序。
- 阅读关注点
- 应核对进展后的随访终止规则、半竞争风险模型、效用 elicitation 的依据，以及所称抗模型误设性质和检验校准。
- 阅读边界
- 索引摘要版本未注明；这是试验设计与模拟研究，未报告实际治疗比较结果，稳健性范围、操作特征及效用设定细节未说明。
原文摘要
A design is presented for a randomized clinical trial comparing two second-line treatments, chemotherapy versus chemotherapy plus reirradiation, for treatment of recurrent non-small-cell lung cancer. The central research question is whether the potential efficacy benefit that adding reirradiation to chemotherapy may provide justifies its potential for increasing the risk of toxicity. The design uses two co-primary outcomes: time to disease progression or death, and time to severe toxicity. Because patients may be given an active third-line treatment at disease progression that confounds second-line treatment effects on toxicity and survival following disease progression, for the purpose of this comparative study follow-up ends at disease progression or death. In contrast, follow-up for disease progression or death continues after severe toxicity, so these are semi-competing risks. A conditionally conjugate Bayesian model that is robust to misspecification is formulated using piecewise exponential distributions. A numerical utility function is elicited from the physicians that characterizes desirabilities of the possible co-primary outcome realizations. A comparative test based on posterior mean utilities is proposed. A simulation study is presented to evaluate test performance for a variety of treatment differences, and a sensitivity assessment to the elicited utility function is performed. General guidelines are given for constructing a design in similar settings, and a computer program for simulation and trial conduct is provided.