在局部晚期直肠癌中接受新辅助化疗或放射治疗后,与病态完全缓解相关的因素:现实世界的临床环境
Minglin Lin1,2, Junsheng Liu1, Chongyuan Lan1
1Department of Colorectal and Anal Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Frontiers in oncology
|August 22, 2024
概括
年龄较小,瘤较小,CEA水平较低,非性腺癌预测新辅助化学放射治疗 (nCRT) 后局部晚期直肠癌 (LARC) 的病理完全缓解 (pCR). 在nCRT后的临床分期准确性需要改进.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 医学研究 医学研究
背景情况:
- 局部晚期直肠癌 (LARC) 需要有效的新辅助化学放射治疗 (nCRT) 来改善结果.
- 病态完全缓解 (pCR) 是LARC治疗成功的一个关键指标.
- 识别pCR的预测因素可以优化治疗策略和患者选择.
研究的目的:
- 确定与在nCRT后LARC患者中实现pCR相关的临床和病理因素.
- 为了评估临床重新分期 (MRI) 的准确性,与在nCRT后的术后病理分期相比.
主要方法:
- 在2015-2021年期间接受治疗的171名LARC患者的队列分析.
- 使用单变量和多变量逻辑回归分析来确定pCR的预测因素.
- 卡帕统计评估了临床和病理阶段之间的一致性.
主要成果:
- 23.4%的患者获得了pCR (TRG 0).
- 年龄较小,瘤周长较小,非性腺癌和较低的nCRT前CEA水平独立地与pCR相关.
- 临床T阶段测定与病理阶段测定不太一致 (Kappa=0.012),而N阶段测定显示边际一致 (Kappa=0.205).
结论:
- 年轻的患者,具有较小瘤,较低CEA和非性腺癌的患者在nCRT后更有可能发生pCR.
- 目前在nCRT后的临床重新分期方法对LARC缺乏足够的准确性,需要改进的评估技术.
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