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在经过新辅助化学放射治疗后,食道癌患者是否需要术后辅助放射治疗? 一个基于SEER数据库的分析

Qiuying An¹, Yuhao Su¹, Yajing Wang¹

¹From the Department of Radiation Oncology (An, Su, Wang, Zhen, Bai, Fu, Zhang, Zhou) and from the Department of Medical Oncology (Liu), The Fourth Hospital of Hebei Medical University, Hebei Province, China.

Saudi medical journal

|September 1, 2024

概括

在新辅助化学放射治疗 (NCRT) 和食道癌 (EC) 手术后的辅助放射治疗没有改善整体存活率. 然而,它可能有利于患有晚期瘤 (cT3-4) 的患者,这些瘤的下降阶段为N0-1.

科学领域:

在瘤学瘤学.
手术瘤学手术瘤学
辐射瘤学辐射瘤学

背景情况:

食道癌 (EC) 治疗通常涉及新辅助化学放射治疗 (NCRT),然后进行手术 (食道切除术).
在NCRT和食道切除术后辅助治疗的作用仍然是研究的关键领域.
优化治疗策略对于改善EC患者的治疗结果至关重要.

研究的目的:

评估辅助放射治疗 (RT) 在食道癌 (EC) 患者的疗效,这些患者在NCRT后接受了食道切除术.
为了比较接受辅助放射疗法或无化疗 (RT±CT) 和仅接受辅助化疗 (CT) 的患者之间的结果.

主要方法:

来自SEER数据库 (2004-2019) 的EC患者的回顾性分析,这些患者在NCRT后接受了辅助治疗.
患者被分为RT±CT和CT组.
使用倾向分数匹配 (PSM) 来最大限度地减少混因素,并确保可比较的组.

主要成果:

在PSM后,RT±CT和CT组之间没有观察到总生存率 (OS) 或癌症特异性生存率 (CSS) 的显著差异.
然而,一组患有cT3-4瘤和N期下降阶段的患者显示,与CT单独相比,辅助RT±CT的5年后的OS和CSS显著改善.
瘤组织学等级被确定为OS和CSS的独立预后因素.

结论:

基于放射治疗的辅助疗法通常不会改善EC患者在NCRT和食道切除术后的预后.
对于特定的子组存在潜在的生存益处,特别是那些患有cT3-4瘤的子组,这些瘤下降到N0-1.
进一步的研究是有必要的,以完善患者选择辅助放射治疗在欧洲共同体.

关键词:

塞尔·塞尔 (Seer) 是一个看得见的人.辅助疗法是一种辅助疗法.这是食道癌的癌症.消化管切除术是指消化管切除术.新辅助性化疗或放射治疗.

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