维持一线疗法加辐射疗法可能会延长无进展的生存时间,并延迟二线疗法对寡进性肝细胞癌的治疗
Boyu Leng1, Haohua Wang2, Yunfan Ge3
1Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China.
International journal of radiation oncology, biology, physics
|January 17, 2025
概括
维持一线全身疗法加辐射疗法 (m-FLST + RT) 显著改善了肝细胞癌患者的无进展生存率. 这一策略为二线治疗提供了一个有希望的替代方案.
科学领域:
- 肝细胞癌 (HCC) 治疗策略 治疗策略
- 在瘤学中进行寡进管理.
- 在肝癌中进行放射治疗.
背景情况:
- 在一线全身疗法 (FLST) 后,肝细胞癌 (HCC) 的最佳治疗方法尚未明确.
- 以有限的病变进展为特征的寡进,在HCC管理中提出了独特的挑战.
- 评估治疗疗效需要将持续的FLST与二线选择进行比较.
研究的目的:
- 为了确定是否保持FLST加放射治疗 (m-FLST + RT) 对于寡进性病变,可以与二线全身疗法 (s-SLST) 相比的无进展生存率 (PFS).
- 在HCC患者中,将m-FLST + RT与单独的s-SLST或与RT (s-SLST + RT) 相比较.
- 为了确定最佳的治疗方法对HCC的寡进.
主要方法:
- 在7个医疗中心 (2018年10月 - 2024年2月) 进行了一项前性研究,涉及154名FLST后Oligoprogression的HCC患者.
- 患者被分为三个组:m-FLST + RT,s-SLST + RT,或s-SLST-only.患者被分为三个组:m-FLST + RT,s-SLST + RT,或s-SLST-only.
- 主要结局是无进展生存期 (PFS);还分析了复发模式.
主要成果:
- 与s-SLST-only (3.1个月) 和s-SLST + RT (5.8个月) 相比,m-FLST + RT组的PFS中位数显著更长 (8.6个月).
- 专白素 (ALBI) 级别和治疗策略是PFS的独立预后因素.
- 与二线疗法相比,m-FLST + RT的病变再扩大率较低.
结论:
- 维持一线全身疗法与辐射疗法 (m-FLST + RT) 结合的维持对HCC患者具有寡进的患者具有潜在的临床益处.
- 这一策略可以避免在特定患者中需要二线全身疗法 (s-SLST).
- 这些发现为优化寡进性HCC的治疗策略提供了宝贵的见解.
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