新辅助剂与辅助剂放射治疗可切除局部晚期胃癌:A SEER人口分析
Guangrong Yang1, Qiao Yang2, Lin Cui3
1Department of Oncology, The People's Hospital of Qijiang District, Chongqing 401420, China.
Heliyon
|February 15, 2024
概括
对于可切除的局部晚期胃癌 (LAGC),辅助放射治疗 (RT) 提供了比新辅助RT更大的生存益处. 这一发现表明辅助RT是特定患者亚组的优越治疗选择.
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:
- 关于新辅助剂与辅助剂放射治疗 (RT) 在可切除局部晚期胃癌 (LAGC) 的疗效的证据有限.
- 胃癌治疗决策需要仔细考虑RT时间,以优化患者的治疗结果.
研究的目的:
- 在可切除局部晚期胃癌 (LAGC) 患者中,比较新辅助与辅助RT的生存结果.
- 确定LAGC患者的特定亚组,与新辅助RT相比,他们可能从辅助RT中获益更多.
主要方法:
- 从SEER数据库 (2004-2015) 中对4790名手术治疗的LAGC患者进行了回顾性分析.
- 卡普兰-梅尔分析和日志等级测试用于生存比较.
- 单变Cox回归用于确定危险比率 (HR) 和置信区间 (CI).
主要成果:
- 与新辅助RT相比,辅助RT在肠道 (49个月与36个月) 和扩散 (32个月与26个月) 亚型中显示出更高的癌症特异生存率 (mCSS) 中位数.
- 特定的子组,包括肠道T1-2N+,T3N-,T3N+和扩散T1-2N+,T3N+患者,从辅助RT中获得更大的益处.
- 辅助性RT还在65岁以上的扩散亚型患者和女性以及在T4N+患者的倾向性得分匹配后显示出生存优势.
结论:
- 辅助RT为T1-2N+,T3N和T3N+临床子组内的可切除LAGC患者提供了比新辅助RT更显著的生存益处.
- 这些发现支持对这些特定患者群体考虑辅助RT而不是新辅助RT.
- 未来的临床试验有必要进一步验证这些结果,并完善LAGC的治疗策略.
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