对于复发性食道癌的绝对化疗放射治疗后的复发模式,治疗方法和预后因素
Keiko Akahane1, Shogo Hatanaka2, Masahiro Kawahara1
1Department of Radiology, Jichi Medical University Saitama Medical Center, 1-847, Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan.
Journal of gastrointestinal cancer
|January 27, 2024
概括
化学放射治疗 (CRT) 后的食道癌 (EC) 复发的结果很差. 积极的局部治疗可能会改善有限复发 (原复发) 患者的存活率.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 癌症研究 癌症研究
背景情况:
- 绝对化疗放射治疗 (CRT) 后的食道癌 (EC) 复发是一个重大的临床挑战,复发模式和治疗结果不明.
- 了解这些模式和预后因素对于改善患者存活率和指导治疗策略至关重要.
研究的目的:
- 分析复发模式,并确定与存活相关的预后因素,在确定的CRT后患有复发性食道癌的患者.
- 评估不同治疗方式对复发后整体存活率的影响.
主要方法:
- 对71名复发性EC后终极CRT患者 (2008-2021) 的回顾性审查.
- 分析复发类型 (局部区域,远程,联合),复发时间和治疗方式 (局部,全身,息).
- 使用Kaplan-Meier和Cox的比例危险模型来评估整体存活率 (OS).
主要成果:
- 复发后的中位生存时间 (MST) 为12.5个月.
- 地方区域复发是最常见的 (59%).
- 多变量分析确定了治疗方法和形复发作为独立的预后因素,局部治疗显示出优异的结果 (MST未达到vs. 系统和息护理的11.8个月和4.1个月,分别).
结论:
- 应强烈考虑对复发性EC患者进行积极的局部治疗,特别是那些有形复发的患者.
- 治疗决策应根据个体的复发模式和患者状况进行调整,以优化预后.
相关概念视频
Barrett Esophagus-II: Clinical Manifestations and Management
154
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
154
Barrett Esophagus-I: Introduction
98
Barrett's esophagus is a medical condition where the esophageal mucosa is significantly damaged by stomach acid or other digestive fluids, often due to long-term exposure associated with gastroesophageal reflux disease (GERD). In GERD, a weakened or abnormally relaxed lower esophageal sphincter allows stomach acid to flow persistently into the esophagus.
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
98
Gastroesophageal Reflux Disease II: Clinical Features and Management
86
Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
86
Cancer Survival Analysis
348
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
348
Esophageal Perforation-II: Clinical Manifestations and Management
64
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
64
Esophageal Strictures-I: Introduction
102
Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
102


