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在局部晚期直肠癌中,在全新辅助疗法和标准新辅助化学放射治疗后的多模式评估准确地预测了完全响应者

Emre Özoran¹, İbrahim Halil Özata², Derya Salim Uymaz²

¹Department of General Surgery, Koç University School of Medicine, Istanbul, Turkey. eozoran@ku.edu.tr.

International journal of colorectal disease

|September 14, 2023

概括

在直肠癌患者中,全新辅助疗法 (TNT) 与标准化疗放射治疗 (SNCRT) 相比,显示出更高的完全响应率. 然而,这并没有导致在本研究中改善生存结果.

科学领域:

在瘤学瘤学.
胃肠病学胃肠病学
手术瘤学手术瘤学

背景情况:

局部晚期直肠癌 (LARC) 需要有效的新辅助治疗策略来改善结果.
总的新辅助疗法 (TNT) 是一种不断发展的方法,旨在提高手术前治疗的疗效.
标准的新辅助化学放射治疗 (SNCRT) 仍然是LARC的常见治疗方式.

研究的目的:

在严格选择的LARC患者中比较TNT和SNCRT之间的局部再生率.
评估二次结果,包括4年无病生存率 (DFS) 和整体生存率 (OS).
评估多模式评估在识别全响应者后新辅助疗法的有效性.

主要方法:

在2014年1月至2021年1月期间接受治疗的LARC患者的回顾性分析.
用数字直肠检查,内镜和MRI评估患者的完整反应.
系统性评估包括腹部上部MRI和胸部CT.

主要成果:

与SNCRT (20.0%) 相比,在TNT组 (45.4%) 观察到更高的累积完全响应率 (p < 0.0001).
在TNT (10.8%) 和SNCRT (23.1%) (p = 0.357) 之间,本地复生率没有显著差异.
在两组治疗中,病理结局和4年DFS和OS率在两组治疗中是可比的.

结论:

多模式评估有效地识别了TNT后的完整响应者,导致局部复发率低.
与SNCRT相比,TNT显示累积完整反应率增加.
尽管反应率有所提高,但TNT在这个LARC队列中并没有转化为显著的生存优势.

关键词:

巩固化疗是一种强化化疗法.诱导化疗是一种诱导化疗.这是直肠癌.标准的新辅助化学或放射治疗.总的新辅助疗法治疗.

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