在患有II或III期结肠癌患者的整体和结肠癌特异性死亡率上更频繁或少频繁的随机临床试验的影响
Peer Wille-Jørgensen1, Ingvar Syk2, Kenneth Smedh3
1Abdominal Disease Center, Bispebjerg Hospital and Danish Colorectal Cancer Group, Copenhagen, Denmark.
JAMA
|May 26, 2018
概括
使用频繁的计算机断层扫描和癌胚抗原测试对结肠直肠癌患者进行密集的随访,与较少频繁的测试相比,并没有显著降低死亡率或复发率.
科学领域:
- 癌症学
- 临床试验
- 癌症查
背景情况:
- 在结肠直肠癌手术后进行密集的随访是标准的,但其对生存的益处尚未得到充分证实.
- 对于第二阶段或第三阶段结直肠癌的最佳后续计划需要进一步调查.
研究的目的:
- 为了比较高频与低频随访计划的有效性.
- 评估对整体死亡率,直肠癌特异性死亡率和复发率的影响.
主要方法:
- 一项非盲目的随机试验涉及2509名患有II或III期结直肠癌的患者.
- 患者接受高频率 (6, 12, 18, 24, 36 个月) 或低频率 (12, 36 个月) 的CT扫描和CEA检查.
- 随访时间为5年.
主要成果:
- 两组之间5年总死亡率 (13. 0% vs 14. 1%) 或癌症特异性死亡率 (10. 6% vs 11. 4%) 没有显著差异.
- 结肠直肠癌的复发率也是相似的 (21. 6%与19. 4%).
结论:
- 使用计算机断层扫描和癌胚抗原进行更频繁的后续检测并不能显著改善II或III期结肠直肠癌患者的生存结果.
- 目前的后续策略可能需要根据这些发现进行重新评估.
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