[新辅助化学放射疗法与新辅助化学免疫疗法治疗局部晚期食道状细胞癌]
1Postgraduate Training Base Alliance of Wenzhou Medical University (Zhejiang Cancer Hospital), Hangzhou310022, China.
Zhonghua zhong liu za zhi [Chinese journal of oncology]
|December 2, 2024
概括
与新辅助化学免疫疗法 (nCRT) 相比,新辅助化学免疫疗法 (nCIT) 显著改善了局部晚期食道状细胞癌 (ESCC) 的生存结果. 即使在较低的病理完整响应率下,这种情况也是如此,强调了nCITIT.
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:
- 局部发达的食道状细胞癌 (ESCC) 需要有效的新辅助治疗策略.
- 新辅助化学放射疗法 (nCRT) 是一种标准治疗方法,但新辅助化学免疫疗法 (nCIT) 正在出现.
- 将nCRT和nCIT的临床疗效进行比较对于优化患者治疗结果至关重要.
研究的目的:
- 为了比较新辅助化学放射治疗 (nCRT) 和新辅助化学免疫治疗 (nCIT) 在局部发达ESCC患者的临床疗效.
- 评估nCRT和nCIT之间的病理反应,疾病复发和生存率的差异.
主要方法:
- 对接受nCRT的155名患者和接受nCIT的470名患者的临床数据进行了回顾性分析,用于局部先进的ESCC.
- 使用倾向分数匹配 (PSM) 来创建可比的组 (120在nCRT中,192在nCIT中).
- 使用日志等级测试和考克斯回归方法,比较R0切除率,病理完整响应 (pCR) 率,复发模式和生存结果 (无疾病生存率,总生存率).
主要成果:
- 在PSM后的nCRT (93.3%) 和nCIT (93.8%) 组中,R0切除率相似 (P=0.884).
- 与nCIT组 (21.4%) (P=0.003) 相比,nCRT组中的pCR率明显高 (36.7%).
- 与nCRT相比,新辅助化疗免疫疗法 (nCIT) 显著改善了3年无疾病生存率 (66.1%与52.7%,P=0.022) 和整体生存率 (75.5%与59.2%,P=0.002). nCIT是一个独立的预后因素,延长了生存时间 (DFS HR=0.58,OS HR=0.53).
结论:
- 新辅助化学免疫疗法 (nCIT) 对局部发达ESCC的新辅助化学放射疗法 (nCRT) 提供了优越的生存益处.
- 尽管病理完整反应率较低,但nCIT显著改善了无病和整体存活率.
- 新辅助疗法模式是局部发达ESCC的独立预后因素.
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