在患有食道癌的患者接受新辅助治疗后,病理完整反应后的瘤复发 - - 一项回顾性队列研究
Julian Hipp1, Jasmina Kuvendjiska1, Hans Christian Hillebrecht1
1Department of General and Visceral Surgery, Medical Center - University of Freiburg, Hugstetter Str. 55, 79100, Freiburg, Germany.
Langenbeck's archives of surgery
|September 18, 2023
概括
远程复发是食道癌患者治疗失败的主要原因,无论病理完整反应 (pCR) 是否. 没有pCR的患者面临明显更高的复发率和更差的生存结果.
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:
- 食道癌症的治疗通常涉及新辅助疗法.
- 在新辅助疗法后评估复发模式对于患者的治疗结果至关重要.
- 区分病理完整反应 (pCR) 和残留淋巴病 (非pCR) 是关键的.
研究的目的:
- 评估食道癌患者的复发模式.
- 为了比较pCR实现的患者与残留淋巴病 (非pCR) 患者的结果.
- 为了比较FLOT化疗与CROSS化疗照射方案的疗效.
主要方法:
- 75名食道癌患者 (63名PCR,12名非PCR) 的回顾性分析.
- 评估局部和远程复发模式及其对整体存活率 (OS) 和无病存活率 (DFS) 的影响.
- 新辅助化疗 (FLOT) 与化疗辐射 (CROSS) 方案的比较.
主要成果:
- 远程复发是PCR (13%) 和非PCR (73%) 组的主要失败模式.
- 没有pCR的患者远期复发的累积发病率显著更高 (79%对16%).
- 病理完整反应 (pCR) 与显著改善的OS和DFS有关. 与CROSS相比,FLOT协议在远程疾病控制方面显示出优势.
结论:
- 远程复发是食道癌后新辅助疗法治疗失败的主要地点.
- 缺乏病理完整反应 (非pCR) 的患者的复发率显著更高.
- 与FLOT的新辅助化疗相比,与CROSS化疗辐射相比,可以提供更好的远程疾病控制.
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