诱导化疗,然后对晚期食道癌进行反应评估和食道切除术
Charlène J van der Zijden1, Pieter C van der Sluis1, Bianca Mostert2
1Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
诱导化疗之后的手术可以为一些患有晚期食道癌的患者提供大约30%的5年生存率. 这种方法可以改善那些最初不符合治愈治疗条件的人的结果.
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:
- 晚期食道癌往往呈现出不良预后,限制了治疗选择.
- 标准的新辅助疗法之后的手术可能不适合所有患者.
- 诱导化疗为改善切除能力和生存结果提供了一个替代方案.
研究的目的:
- 为了评估诱导化疗在患有晚期食道癌症的患者的结果.
- 为了确定与诱导化疗和手术后的生存相关的患者和瘤特征.
主要方法:
- 对238名用诱导化疗治疗的食道或结节癌症患者 (2005-2021) 的回顾性分析.
- 通过 (18F-FDG PET) /CT评估反应,由多学科瘤委员会做出治疗决定.
- 使用卡普兰-梅尔法计算的整体存活期 (OS);进行单变量和多变量分析.
主要成果:
- 在诱导化疗后,127名患者 (53.4%) 接受了切除.
- 平均生存期为26.3个月,五年生存期为29.6%.
- T4b阶段和差异化瘤与更差的存活率相关 (p=0.04).
结论:
- 诱导化疗之后的食道切除术可以在精心挑选的患者中达到大约30%的5年生存率.
- 这一策略为晚期食道癌患者提供了潜在的治疗选择,这些患者最初不适应标准治疗.
- 瘤阶段和分化是影响生存结果的关键预后因素.
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