局部晚期直肠癌的全新辅助疗法与新辅助化学辐射:一个多机构的现实世界研究
Elif Şenocak Taşçı1, Arda Ulaş Mutlu2, Onur Saylık3
1Department of Medical Oncology, Kanuni Sultan Süleyman Training and Research Hospital, 34295 Istanbul, Turkey.
Cancers
|September 28, 2024
概括
全新辅助疗法 (TNT) 通过增加病理完整反应 (pCR) 并使非手术治疗成为可能,改善局部晚期直肠癌 (LARC) 的结果. 这种方法比标准化疗辐射疗法 (CRT) 具有显著的优势.
科学领域:
- 在瘤学瘤学.
- 胃肠道癌症研究研究
- 手术瘤学手术瘤学
背景情况:
- 局部晚期直肠癌 (LARC) 管理传统上涉及化疗放射治疗 (CRT).
- 整体新辅助疗法 (TNT) 整合了手术前的化疗和放射治疗,以优化治疗.
- TNT旨在提高切除能力,病理完整反应 (pCR) 和患者存活率.
研究的目的:
- 在LARC患者中比较TNT与标准CRT的临床结果.
- 评估TNT对pCR,生存率和非操作性管理 (NOM) 的影响.
- 分析TNT (诱导与巩固化疗) 中的治疗序列.
主要方法:
- 对276名II-III期LARC患者 (2021-2024) 的多机构回顾性分析.
- 接受CRT (n=105) 和TNT (n=171) 的患者之间的比较.
- 按化疗序列 (诱导或巩固) 分层的TNT组.
主要成果:
- 与CRT相比,TNT显著增加了pCR率 (21.8%与2.9%,p < 0.001).
- 在TNT中,淋巴,血管和神经周围神经的侵袭率较低.
- 较高的NOM率 (16.9%与0.9%,p<0.001) 和较长的手术间隔被观察到与TNT.
结论:
- 与标准CRT相比,全新辅助疗法是LARC的优越治疗策略.
- TNT增强了病态的完整反应,减少了瘤的入侵,并增加了非手术的管理选择.
- 在LARC患者的生存和生活质量方面,TNT提供了潜在的改善.
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