低剂量辐射在食道癌患者中产生较低的病理反应率
Styliani Mantziari1,2, Hugo Teixeira Farinha3,4, Marguerite Messier5
1Department of Visceral Surgery, Lausanne University Hospital CHUV, Lausanne, Switzerland. styliani.mantziari@chuv.ch.
Annals of surgical oncology
|January 10, 2024
概括
较高的手术前辐射剂量 (50.4 Gy) 改善了食道癌患者的病理完整反应 (pCR) 率. 然而,辐射剂量没有影响生存率或复发率,这表明需要进一步研究最佳剂量策略.
科学领域:
- 在瘤学瘤学.
- 辐射瘤学 辐射瘤学
- 手术瘤学手术瘤学
背景情况:
- 经过手术后的新辅助化疗 (nCRT) 是局部发达的食道或胃食道结 (E/GEJ) 癌症的标准.
- 在E/GEJ癌症中,nCRT的最佳辐射剂量仍在研究中.
研究的目的:
- 评估不同手术前辐射剂量 (41.4 Gy,45 Gy,50.4 Gy) 对病理反应和生存结果的影响.
- 为了比较E/GEJ癌症患者不同辐射剂量之间的结果,单独分析腺癌 (AC) 和状细胞癌 (SCC).
主要方法:
- 在2009年至2016年间,对326名连续接受治疗的E/GEJ癌症患者进行了回顾性分析.
- 根据手术前的放射治疗剂量,患者被分为三组:41.4 Gy,45 Gy或50.4 Gy.
- 评估的结果包括病理完整反应 (pCR),术后发病率,整体存活率 (OS) 和无病存活率 (DFS).
主要成果:
- 50.4 Gy 的更高辐射剂量独立地与增加pCR的可能性有关 (或2.78).
- pCR率分别为15% (41.4 Gy),30% (45 Gy) 和34% (50.4 Gy) (p=0.047) 的情况.
- 在腺癌患者中,pCR率因剂量而异 (6.2% vs 29.2% vs 22.7%,p=0.035),但在剂量组之间没有观察到OS或DFS的差异.
结论:
- 术前辐射剂量为41.4 Gy与腺癌患者的pCR率较低有关.
- 辐射剂量没有显著影响术后并发症,长期存活率或复发率.
- 这些发现表明,较高的辐射剂量可能会增强病理反应,但它们对整体存活率的影响需要进一步调查.
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