在新辅助化学辐射后预测食道腺癌的预测结果:瘤反应和存活率之间的相互作用
Daniel Solomon1, Ashley L Deeb1, Kamal Tarabine2
1Division of Thoracic and Cardiac Surgery, Brigham and Women's Hospital, Boston, Mass.
The Journal of thoracic and cardiovascular surgery
|November 15, 2023
概括
瘤回归分数 (TRS) 预测新辅助化学辐射治疗后食道腺癌 (EAC) 患者的存活率. 病理完整反应显著改善整体存活率 (OS),而标记细胞和高SUV吸收预测较差的结果.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 放射学 放射学是一门学科.
背景情况:
- 在新辅助化学辐射治疗后食道腺癌 (EAC) 瘤回归得分 (TRS) 的预后值尚未完全理解.
- 调查病理和代谢治疗反应对于EAC患者的治疗结果至关重要.
研究的目的:
- 为了评估瘤回归得分 (TRS) 和代谢反应在接受新辅助化学辐射治疗的EAC患者的预后意义.
- 为了确定残留疾病和整体存活率 (OS) 的预测因素.
主要方法:
- 对277名接受新辅助CROSS协议化学辐射和食道切除术的EAC患者的回顾性分析.
- 瘤回归得分 (TRS) 通过修改的瑞安得分进行评估;代谢反应通过PERCIST标准.
- 收集的数据包括内镜超声波,活检和PET/CTSUV用于原发性瘤和淋巴结.
主要成果:
- 病理完整响应 (TRS 0) 在23.8%的患者中观察到,并且与显著更长的生存时间有关.
- 活检上的标签环细胞特征和更高的区域淋巴结SUV吸收预测了残留疾病.
- 在节点站中较高的SUVmax独立预测了下降的OS,而病理完整反应预测了更高的OS.
结论:
- 病理完整反应是EAC患者延长OS的强有力的预测因素.
- 标签环细胞和高区域淋巴结SUV吸收在初始阶段预测残留疾病和较短的OS.
- 这些发现凸显了对高风险EAC患者新型治疗策略的需求.
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