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可切除胃癌的新辅助化疗与新辅助化疗辐射治疗相比,与更好的结果有关

Hideo Takahashi^1,2, Masaya Nakauchi³, Spiros Hiotis²

¹Department of Surgery, Mount Sinai South Nassau, Oceanside, New York, USA.

Journal of surgical oncology

|July 31, 2024

概括

新辅助化疗 (CTx) 为晚期胃癌提供了比化疗 (CRTx) 更好的存活率. 这项研究发现CTx显著改善了整体存活率,这表明需要重新评估当前的治疗指南和分期系统.

科学领域:

在瘤学瘤学.
手术瘤学手术瘤学
胃肠道瘤学胃肠道瘤学

背景情况:

国家综合癌症网络指导方针建议新辅助化疗 (CTx) 或化疗辐射 (CRTx) 治疗晚期切除性胃癌.
治疗决策通常不论瘤的位置.

研究的目的:

为了比较新辅助CTx与CRTx对晚期切除性胃癌的生存益处.
使用国家癌症数据库 (NCDB) 评估不同新辅助治疗方式的疗效.

主要方法:

在2004年至2018年期间使用NCDB进行了14266名经过新辅助治疗 (CTx或CRTx) 胃切除术的患者的回顾性审查.
在治疗组之间比较人口统计学,临床因素,病理反应和整体存活率 (OS).
亚组分析和多变量分析以确定独立的预后因素并评估不同阶段的治疗影响.

主要成果:

与新辅助CRTx相比,新辅助CTx与明显更长的整体存活 (OS) 相关 (p < 0.001).
接受CTx治疗的患者在各种AJCC T/N类别中显示了20%-30%的改善5年生存率.
新辅助性CTx被确定为生存的独立保护因子 (HR=0.811,p < 0.001).

结论:

与新辅助CRTx相比,新辅助CTx在晚期切除性胃癌中提供了更好的生存结果.
目前的AJCC分期可能会高估接受新辅助CRTx治疗的患者的存活率.
这些发现支持胃癌治疗建议的潜在转变.

关键词:

胃腺癌胃腺癌胃腺癌新辅助疗法是一种新辅助疗法.幸存率幸存率生存率

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