与整体新辅助疗法相关的结果,用于直肠腺癌的非手术意图
Ebenezer Asare1, Emily Venner2, Hanna Batchelor2
1Department of Radiation Oncology, University of Virginia, Charlottesville, VA, United States.
Frontiers in oncology
|August 19, 2024
概括
总的新辅助疗法 (TNT) 对直肠腺癌具有前景,临床完整反应 (cCR) 和器官保存率高. 化疗辐射后的早期反应评估 (CRT) 预测了成功的非手术管理,支持TNT作为选择患者的可行选择.
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:
- 结直肠腺癌的治疗传统上涉及手术,往往导致显著的发病率.
- 全新辅助疗法 (TNT) 在最终治疗之前整合了新辅助化疗和化疗辐射 (CRT),旨在改善结果.
- 非手术治疗 (NOM) 正在越来越多地探索直肠癌,特别是在有效的新辅助治疗后.
研究的目的:
- 评估用TNT治疗的直肠腺癌患者的临床完整响应 (cCR) 率,以非手术治疗为目标.
- 为了评估TNT后的无手术和永久性无骨生存率.
- 为了确定与患者接受TNT进行直肠癌的成功结果相关的因素.
主要方法:
- 以TNT (2013-2022) 治疗的45名II-IV期直肠腺癌患者的回顾性审查.
- 所有患者都接受了CRT,加上capecitabine和额外的化疗,顺序有所变化.
- 使用Kaplan-Meier和Cox回归分析来确定生存结果和相关因素.
主要成果:
- 64.4%的患者在TNT后获得了cCR.
- 一年和两年无手术生存率分别为77.3%和66.2%.
- 在CRT内镜后6个月的cCR预测了更好的无手术和永久的无瘤生存率.
结论:
- 对于精选的直肠腺癌患者来说,TNT可以是一个成功的非手术选择,促进器官的保存.
- 早期临床反应评估 (CRT内镜后6个月) 是长期无手术和无瘤生存的关键预测指标.
- 在巩固化疗之前对CRT进行测序与较高的cCR和较低的手术率有关.
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