在局部晚期直肠癌中,什么预测了对全新辅助疗法的完整反应?
Sumeyye Yilmaz1, David Liska1, Madison L Conces2
1Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio.
Diseases of the colon and rectum
|September 11, 2024
概括
对直肠癌的全新辅助疗法实现了37%的完全响应率. 低直肠瘤和没有外壁血管入侵预测了反应,与MRI和西格莫视镜相结合,提高了预测准确度.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
背景情况:
- 治疗第二期和第三期直肠癌的全新辅助疗法 (TNT) 涉及手术前的化疗和化疗辐射.
- TNT与更高的完整反应率有关,定义为病理完整反应或持续的临床完整反应.
研究的目的:
- 确定在直肠癌中对TNT的完整反应的预测因素.
- 比较诊断工具 (信号显微镜,MRI) 以预测完整的反应.
主要方法:
- 在一个单一的第三级护理中心进行了回顾性队列研究.
- 包括119名在2015-2021年期间用TNT治疗的II-III期直肠癌患者.
- 评估完整响应率,预测因素和诊断工具准确度.
主要成果:
- 总体完整反应率为37%.
- 低直肠瘤 (OR 1.5) 和没有外壁血管侵袭 (OR 2.2) 是完全反应的预测因素.
- 在预测响应方面,西格莫显微镜显示出比MRI (62.5%,69.2%) 更高的灵敏度 (76.0%) 和特异性 (72.5%);联合技术提高了特异性,达到82.5%.
结论:
- 用TNT治疗直肠癌的完全响应率为37%.
- 低直肠瘤和没有EMVI是响应的关键预测因素.
- 综合MRI和西格莫多斯科比提供了完整反应的最佳预测.
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