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用新辅助化学放射治疗治疗的T4和/或N2直肠癌的临床结果:一项回顾性研究

Sarah Unrau¹, Mansi Barthwal², Lavanya Gurram³

¹University of Manitoba, Manitoba, Canada.

Clinical colorectal cancer

|July 4, 2024

概括

与标准治疗相比,全新辅助疗法 (TNT) 并没有改善局部晚期直肠癌 (LARC) 的存活率. 然而,辅助化疗 (ACT) 显示了生存益处,特别是在N2疾病中,突出显示了LARC的个性化治疗需求.

科学领域:

结肠直肠手术结肠直肠手术
手术瘤学手术瘤学
胃肠病学胃肠病学

背景情况:

针对局部晚期直肠癌 (LARC) 进行了全新辅助疗法 (TNT) 的研究,但其对标准化疗放射治疗的生存益处尚未确定.
现有的TNT试验未能将个人高风险特征在LARC管理中的影响隔离出来.

研究的目的:

为了评估LARC患者的临床结果T4和/或N2疾病治疗新辅助化疗和放射治疗,其次是全腹膜切除 (TME).
评估辅助化疗 (ACT) 对特定高风险LARC亚组的生存和复发的影响.

主要方法:

在2007-2019年间在曼尼托巴省接受治疗的331名LARC患者 (T4和/或N2) 的回顾性分析.
数据收集包括人口统计和临床信息,治疗细节,以及对整体存活 (OS) 和局部区域复发 (LRR) 的随访.

主要成果:

在93.4%的患者中实现了R0切除. 3年的整体复发率为29%,地方区域复发率为8%.
三年整体存活率为84%. 不完整的切除是一个不良的预后因素.
辅助化疗 (ACT) 在整体队列和N2亚组中改善了生存率,但在T4亚组中没有改善. ACT没有影响LRR.

结论:

在新辅助疗法后在LARC中实现R0切除对于改善结果至关重要.
T4疾病的预后比N2疾病更糟糕,这表明可能会升级到第三阶段.
考虑到个体高风险特征的个性化治疗策略对于优化TNT时代的LARC管理至关重要.

关键词:

辅助性化疗是一种辅助性化疗.临床结果临床结果局部发达的直肠腺癌癌.新辅助性化疗或放射治疗.T4 和/或 N2 的情况.

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