结直肠癌的完整应答率:在基于人口的全国性队列中,十年的时间变化
Sofieke J D Temmink1, Anna Martling1, Eva Angenete2
1Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
概括
在2009年至2020年期间,直肠癌的整体完全响应率从3.0%大幅增加到9.6%. 病理完整反应保持稳定,但自Watch & Wait研究开始以来,临床完整反应似乎正在取代它.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 临床研究 临床研究
背景情况:
- 对直肠癌的新辅助治疗已经发展,影响治疗结果.
- 完整反应率是评估治疗疗效的关键指标.
- 观察和等待 (WoW) 研究的引入代表了管理策略的重大转变.
研究的目的:
- 分析新增辅助疗法对直肠癌病理和整体完整反应率的影响.
- 评估全国队列中完整响应率的变化,与新辅助治疗修改和WoW研究相关.
- 在十年内调查直肠癌应答率的时间趋势.
主要方法:
- 全国范围的注册研究使用从瑞典结肠直肠癌注册 (2009-2020) 收集的前性数据.
- 包括来自WoW研究的病理完整反应 (ypT0N0) 或临床完整反应的直肠癌患者 (I-III阶段).
- 分析病理和整体完整反应率的时间变化,以及新辅助治疗方案.
主要成果:
- 病理完整响应率保持稳定 (约为1. 0.091),而整体完整反应率从3.0%显著增加到9.6% (p < 0.001).
- 在Wow研究引入后,接受短期放射治疗,然后接受化疗的患者的病理完整反应率下降了50%.
- 在WoW研究开始后,观察到从病理完整反应向临床完整反应的转变.
结论:
- 在直肠癌中,整体完整反应率的显著增加归因于国家新辅助治疗方案的变化.
- 全国WoW研究似乎影响了响应指标,临床完整响应可能取代病理完整响应.
- 不断发展的新辅助剂策略正在重塑直肠癌管理中的完整反应评估.
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